Eastside Periodontal Assoc Pllc

LBN: Eastside Periodontal Assoc Pllc
Eastside Periodontal Assoc Pllc is an health care organization with primary practice located at 25523 Van Dyke Ave , Center Line MI 48015-1824. The organization recently has only one registered license in Dental Providers / Periodontics, which is considered as the primary health care specialty. Eastside Periodontal Assoc Pllc can be contacted via phone (586) 757-5454, or through Wise, Jennifer Lynn via phone (586) 757-5454.

Contact Information

Primary practice address
25523 Van Dyke Ave Center Line MI 48015-1824
Phone: (586) 757-5454
Fax: (586) 757-4147
Website:
Map and Directions
Authorized official contact:
Name: Wise, Jennifer Lynn
Phone: (586) 757-5454

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X B18275 Michigan

Profile Details

NPI number 1144312760
LBN Legal business name Eastside Periodontal Assoc Pllc
DBA Doing business as
Authorized official Wise, Jennifer Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2006
Last updated Aug 22nd, 2020 - about 4 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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