Provider Demographics
NPI:1619767761
Name:DEVOTED DENTAL GROUP WARREN PLLC
Entity type:Organization
Organization Name:DEVOTED DENTAL GROUP WARREN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MEZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-990-8027
Mailing Address - Street 1:29856 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3600
Mailing Address - Country:US
Mailing Address - Phone:586-250-5000
Mailing Address - Fax:
Practice Address - Street 1:29856 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3600
Practice Address - Country:US
Practice Address - Phone:586-250-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental