Organization
MICHAEL J. DEPORRE, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOSEPH DEPORRE D.D.S. (PRESIDENT)
(248) 656-2244
Entity
Organization
Contact information
Practice address
2490 WALTON BLVD, SUITE 202, ROCHESTER HILLS, MI 48309-1484
(248) 656-2244
(248) 656-0225
Mailing address
2490 WALTON BLVD, SUITE 202, ROCHESTER HILLS, MI 48309-1484
(248) 656-2244
(248) 656-0225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13866
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4658155
—
MI
Enumeration date
10/01/2006
Last updated
08/22/2020
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