Peter J Polverini
Dentist Oral and Maxillofacial Pathology
1011 N University Ave
Ann Arbor
, Michigan 48109-1078
Peter J Polverini
Dentist Oral and Maxillofacial Pathology
1011 N University Ave
Ann Arbor
, Michigan 48109-1078
(419) 866-5453
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About
Features
Specialties
- Dentist
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Peter J Polverini
- 5700 Southwyck Blvd
- Toledo, OH
- Zip : 43614-1509
- Fax : (419) 866-5453
- Phone : (800) 288-8325
Second Address
- Peter J Polverini
- 1011 N University Ave
- Ann Arbor, MI
- Zip : 48109-1078
- Fax : (734) 763-5142
- Phone : (734) 763-6933
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 122300000X | Dentist | 2901016040 | MI |
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 2901016040 | MI |
National Provider Identifier
| NPI | 1699808857 |
|---|---|
| Provider Name | Peter J Polverini |
| First Address | Toledo, OH 43614-1509 |
| Second Address | Ann Arbor, MI 48109-1078 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/03/2007 |
| Last Update Date | 29/01/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 195816845 | BCBS OF MI MED SURGICAL (01) | MI |
| 2667583 | (05) | OH |
| 4070694 | (05) | MI |
| 4504373 | (05) | MI |
| 4874042 | (05) | MI |
| D160400 | BCBS OF MI DENTAL (01) | MI |
| U37373 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.