WALLACE COLVIN PC NPI 1952853103

NPI Information

NPI: 1952853103
Provider Name: WALLACE COLVIN PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
69 SOUTHBOUND GRATIOT AVE LOWR
MOUNT CLEMENS, MI
ZIP 48043
Phone: (586) 783-7000
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WALLACE COLVIN PC is a dental clinic center in Mount Clemens, MI. WALLACE COLVIN PC NPI is 1952853103. The provider is registered as an organization entity type.

The provider's business location address is:

69 SOUTHBOUND GRATIOT AVE LOWR
MOUNT CLEMENS, MI
ZIP 48043-600
Phone: (586) 783-7000
Fax: (586) 783-7003

The provider's authorized official is Wallace S Colvin .
The authorized official title is Dentist and has the following contact phone number (586) 783-7000.

The enumeration date for this NPI number is 11/3/2016 and was last updated on 11/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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