Provider Demographics
NPI:1699383695
Name:LAURICH DENTISTRY ANN ARBOR PLLC
Entity type:Organization
Organization Name:LAURICH DENTISTRY ANN ARBOR PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:KARACSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-476-1960
Mailing Address - Street 1:18618 MIDDLEBELT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3586
Mailing Address - Country:US
Mailing Address - Phone:248-476-1960
Mailing Address - Fax:248-479-2805
Practice Address - Street 1:2715 PACKARD ST STE B
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3365
Practice Address - Country:US
Practice Address - Phone:734-975-6700
Practice Address - Fax:734-975-9035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty