Provider Demographics
NPI:1467576686
Name:DUFF, RENEE E (DDS)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:E
Last Name:DUFF
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1012
Mailing Address - Country:US
Mailing Address - Phone:734-647-4246
Mailing Address - Fax:734-647-8090
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1012
Practice Address - Country:US
Practice Address - Phone:734-647-4246
Practice Address - Fax:734-647-8090
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010169321223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID169320OtherBCBS OF MI DENTAL
MI1958111730OtherBCBS OF MI MED SURGICAL