Provider Demographics
NPI:1487735197
Name:DIESING PERRETT, DAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:DIESING PERRETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:ANN
Other - Last Name:DIESING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:32910 W 13 MILE RD STE C304
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1983
Mailing Address - Country:US
Mailing Address - Phone:248-851-6446
Mailing Address - Fax:
Practice Address - Street 1:32910 WEST 13 MILE ROAD
Practice Address - Street 2:SUITE C304
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-851-6446
Practice Address - Fax:248-851-4408
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist