Provider Demographics
NPI:1760276323
Name:KP PREMIER FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:KP PREMIER FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-915-8890
Mailing Address - Street 1:8133 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3518
Mailing Address - Country:US
Mailing Address - Phone:248-509-5555
Mailing Address - Fax:
Practice Address - Street 1:8133 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3518
Practice Address - Country:US
Practice Address - Phone:248-509-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty