Provider Demographics
NPI:1679900021
Name:NOLAN AND GUEST ORTHODONTICS PC
Entity type:Organization
Organization Name:NOLAN AND GUEST ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:734-981-2444
Mailing Address - Street 1:42287 CHERRY HILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1975
Mailing Address - Country:US
Mailing Address - Phone:734-981-2444
Mailing Address - Fax:734-981-5645
Practice Address - Street 1:42287 CHERRY HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1975
Practice Address - Country:US
Practice Address - Phone:734-981-2444
Practice Address - Fax:734-981-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010190851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty