Gardner, Alyssa

Gardner, Alyssa is an individual health care provider with primary practice located at 26800 Summerdale Dr Bldg 3 , Southfield MI 48033-2233. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Gardner, Alyssa can be contacted via phone (248) 986-0881.

Contact Information

Primary practice address
26800 Summerdale Dr Bldg 3 Southfield MI 48033-2233
Phone: (248) 986-0881
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 2902018762 Michigan

Profile Details

NPI number 1154091668
LBN Legal business name Gardner, Alyssa
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2021
Last updated Sep 16th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154091668 NPPES
Michigan MEDICAID 02231991

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