Organization Name: | VITEK FAMILY DENTISTRY, P.C. |
NPI Number: | 1578757506 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALEXA MARIE VITEK (PRESIDENT) |
Mailing Address: | 13173 Schavey Rd Dewitt |
State: | MI US |
Postal Code: | 488209000 |
Phone Number: | 5172772000 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2007 |
NPI Last Update Date: | 09/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 2901018878 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |