Organization Name: | DONALD A. RESTAURI JR DDS PC |
NPI Number: | 1710074729 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD ANTHONY RESTAURI (PRESIDENT/DENTIST) |
Mailing Address: | 5589 E Mi 36 Suite 11 Pinckney |
State: | MI US |
Postal Code: | 481699260 |
Phone Number: | 8102312424 |
Fax Number: | 8102312807 |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 2901013193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |