| Michigan Head & Neck Institute Pc | |
|
3665 E 11 Mile Rd Warren MI 48092-4300 | |
| (586) 573-0438 | |
| (586) 573-0186 |
| Full Name | Michigan Head & Neck Institute Pc |
|---|---|
| Speciality | Dentist |
| Location | 3665 E 11 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Richard E Klein (DDS) |
| Authorized Official Contact | 5865730438 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Head & Neck Institute Pc 3665 E 11 Mile Rd Warren MI 48092-4300 Ph: (586) 573-0438 | Michigan Head & Neck Institute Pc 3665 E 11 Mile Rd Warren MI 48092-4300 Ph: (586) 573-0438 |
| NPI Number | 1104871250 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 06/28/2022 |
| Medicare PECOS PAC ID | 0648344762 |
|---|---|
| Medicare Enrollment ID | O20080807000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104871250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 009174 (Michigan) | Primary |
| Provider Name | Richard E Klein |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225136054 PECOS PAC ID: 5193899219 Enrollment ID: I20080807000017 |
| Provider Name | Chad M Witkow |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1316099179 PECOS PAC ID: 5496060584 Enrollment ID: I20220627001218 |
| Provider Name | Renna Hatahet |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1588272926 PECOS PAC ID: 7416319108 Enrollment ID: I20230811002001 |
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