Diversified Dental, P.C.

LBN: Diversified Dental, P.C.
Diversified Dental, P.C. is an health care organization with primary practice located at 30231 Jefferson Ave , Saint Clair Shores MI 48082-1787. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Diversified Dental, P.C. can be contacted via phone (586) 775-2400, or through Prush, Kevin D via phone (586) 775-2400.

Contact Information

Primary practice address
30231 Jefferson Ave Saint Clair Shores MI 48082-1787
Phone: (586) 775-2400
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Prush, Kevin D Doctor of Dental Surgery (DDS)
Phone: (586) 775-2400

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1669191342
LBN Legal business name Diversified Dental, P.C.
DBA Doing business as
Authorized official Prush, Kevin D Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 25th, 2022
Last updated Aug 25th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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