| Tender Dental Care Pc | |
|
1024 N Genesee Burton MI 48509 | |
| (810) 715-3368 | |
| (810) 715-1663 |
| Full Name | Tender Dental Care Pc |
|---|---|
| Speciality | Dentist |
| Location | 1024 N Genesee, Burton, Michigan |
| Authorized Official Name and Position | Prabha R Raju (OWNER DOCTOR) |
| Authorized Official Contact | 8107153368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tender Dental Care Pc Po Box 90161 1024 N Genesee Burton MI 48509 Ph: (810) 715-3368 | Tender Dental Care Pc 1024 N Genesee Burton MI 48509 Ph: (810) 715-3368 |
| NPI Number | 1073689899 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6204195126 |
|---|---|
| Medicare Enrollment ID | O20180122001361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073689899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15924 (Michigan) | Primary |
| Provider Name | Prabha Raju |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710150925 PECOS PAC ID: 5092075481 Enrollment ID: I20180208001912 |
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