Shane Davidson Dds Pc

LBN: Shane Davidson Dds Pc
Shane Davidson Dds Pc is an health care organization with primary practice located at 5574 Cooley Lake Rd , Waterford MI 48327-3015. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Shane Davidson Dds Pc can be contacted via phone (248) 977-3006, or through Davidson, Shane via phone (248) 977-3006.

Contact Information

Primary practice address
5574 Cooley Lake Rd Waterford MI 48327-3015
Phone: (248) 977-3006
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Davidson, Shane Doctor of Dental Surgery (DDS)
Phone: (248) 977-3006

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2901020222 Michigan

Profile Details

NPI number 1033651427
LBN Legal business name Shane Davidson Dds Pc
DBA Doing business as
Authorized official Davidson, Shane Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 16th, 2016
Last updated Nov 16th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033651427 NPPES
Michigan MEDICAID 2901020222

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