Provider Demographics
NPI:1124144597
Name:ENSPIRE DENTAL PLLC
Entity type:Organization
Organization Name:ENSPIRE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:I
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-663-6777
Mailing Address - Street 1:3100 W LIBERTY RD STE A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8724
Mailing Address - Country:US
Mailing Address - Phone:734-663-6777
Mailing Address - Fax:734-663-9820
Practice Address - Street 1:3100 W LIBERTY RD STE A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8724
Practice Address - Country:US
Practice Address - Phone:734-663-6777
Practice Address - Fax:734-663-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty