Provider Demographics
NPI:1790424034
Name:ROOTS ENDODONTICS PLC
Entity type:Organization
Organization Name:ROOTS ENDODONTICS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-552-2000
Mailing Address - Street 1:6251 GRAND RIVER RD STE 600
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-5321
Mailing Address - Country:US
Mailing Address - Phone:517-552-2000
Mailing Address - Fax:517-552-2885
Practice Address - Street 1:6251 GRAND RIVER RD STE 600
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-5321
Practice Address - Country:US
Practice Address - Phone:517-552-2000
Practice Address - Fax:517-552-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235161860OtherTYPE 1 NPI