Provider Demographics
NPI:1902533904
Name:MICHAEL J. GUEST, JR., D.D.S., P.C.
Entity Type:Organization
Organization Name:MICHAEL J. GUEST, JR., D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUEST
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-885-7776
Mailing Address - Street 1:19557 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2859
Mailing Address - Country:US
Mailing Address - Phone:313-885-7776
Mailing Address - Fax:
Practice Address - Street 1:19557 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2859
Practice Address - Country:US
Practice Address - Phone:313-885-7776
Practice Address - Fax:313-885-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty