| Organization Name: | DOCSMILE DENTAL CENTER |
| NPI Number: | 1417179466 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACEY E JOHNSON-ROBINSON (ADMINISTRATOR) |
| Mailing Address: | 18601 Mack Ave Grosse Pointe |
| State: | MI US |
| Postal Code: | 482363250 |
| Phone Number: | 8003627645 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2007 |
| NPI Last Update Date: | 10/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 292200000X |
| License Number: | 2901015328 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Dental Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A commercial laboratory specializing in the construction of dental appliances that conform to a dentist |