Provider Demographics
NPI:1366109787
Name:EZ DENTISTS PLC
Entity type:Organization
Organization Name:EZ DENTISTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILO
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-982-3720
Mailing Address - Street 1:22211 W WARREN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2597
Mailing Address - Country:US
Mailing Address - Phone:313-982-3720
Mailing Address - Fax:
Practice Address - Street 1:22211 W WARREN ST STE 200
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2597
Practice Address - Country:US
Practice Address - Phone:313-982-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental