Provider Demographics
NPI:1699555235
Name:DELUXE DENTAL ASSOCIATES #8 ROSEVILLE PLLC
Entity type:Organization
Organization Name:DELUXE DENTAL ASSOCIATES #8 ROSEVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHA-KIZY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-820-7766
Mailing Address - Street 1:3760 S DORT HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2045
Mailing Address - Country:US
Mailing Address - Phone:810-820-7766
Mailing Address - Fax:810-243-0454
Practice Address - Street 1:16211 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4334
Practice Address - Country:US
Practice Address - Phone:810-820-7766
Practice Address - Fax:810-243-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty