Provider Demographics
NPI:1861871477
Name:STEPHEN A FLORKOWSKI DDS PC
Entity type:Organization
Organization Name:STEPHEN A FLORKOWSKI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:FLORKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-522-8030
Mailing Address - Street 1:30990 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1803
Mailing Address - Country:US
Mailing Address - Phone:734-522-8030
Mailing Address - Fax:734-522-8987
Practice Address - Street 1:30990 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1803
Practice Address - Country:US
Practice Address - Phone:734-522-8030
Practice Address - Fax:734-522-8987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014764261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental