| American Mobile Dental Pc | |
|
24293 Telegraph Rd Ste 212 Southfield MI 48033-7903 | |
| (888) 628-5535 | |
| (888) 892-3080 |
| Full Name | American Mobile Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 24293 Telegraph Rd Ste 212, Southfield, Michigan |
| Authorized Official Name and Position | Joy Ashteneau (VICE PRESIDENT) |
| Authorized Official Contact | 8886285535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Mobile Dental Pc 24293 Telegraph Rd Ste 212 Southfield MI 48033-7903 Ph: (888) 628-5535 | American Mobile Dental Pc 24293 Telegraph Rd Ste 212 Southfield MI 48033-7903 Ph: (888) 628-5535 |
| NPI Number | 1629166509 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 10/20/2016 |
| Medicare PECOS PAC ID | 1557649530 |
|---|---|
| Medicare Enrollment ID | O20161026000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629166509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Richard L Beckermeyer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982740197 PECOS PAC ID: 3476501578 Enrollment ID: I20050105000687 |
| Provider Name | Allen Wayne Mortimer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972867851 PECOS PAC ID: 3173742293 Enrollment ID: I20140922001729 |
| Provider Name | Christina L Lewis |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356427942 PECOS PAC ID: 1951607969 Enrollment ID: I20161027001764 |
| Provider Name | Lisa D Sostecke |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508889916 PECOS PAC ID: 3971881806 Enrollment ID: I20161028000050 |
| Provider Name | Richard C Scott |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1215044466 PECOS PAC ID: 4789962614 Enrollment ID: I20161028000093 |
| Provider Name | Peter S Graham |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1316926819 PECOS PAC ID: 6305124231 Enrollment ID: I20161028000138 |
| Provider Name | Amy L Janowicz |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720159296 PECOS PAC ID: 9830488568 Enrollment ID: I20161031000304 |
| Provider Name | Ronald G Bonheim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518046440 PECOS PAC ID: 1052699873 Enrollment ID: I20161031000400 |
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