OrganizationActive
Detroit Dental Rx PLLC
NPI 1053254193 · Non-Pharmacy Dispensing Site · Detroit, MI
Provider details
- NPI number
- 1053254193
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Alex Wolicki, Member(586) 558-8004
Specialties & taxonomies
Suppliers
Practice location
15510 Livernois Ave
Detroit, MI 48238-1343
Phone: (313) 217-0014
Fax: (313) 246-1886
Approximate (ZIP-level) locationGet directions
Mailing address
27201 Ryan Rd
Warren, MI 48092-5127
Registry dates
- Enumerated
- 2026-04-13
- Last updated
- 2026-04-13
- Certified
- 2026-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.