Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Eastside Periodontal Assoc PLLC

Organization Periodontics · NPI 1144312760

Eastside Periodontal Assoc PLLC provides Periodontics in Center Line, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25523 Van Dyke Ave
Center Line, MI 48015-1824
Phone: (586) 757-5454
Fax: (586) 757-4147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence B18275 (MI)

Record details

NPI number1144312760
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Wise — Office Manager · (586) 757-5454
NPI enumeratedSeptember 29, 2006
Last updated in NPPESAugust 22, 2020
Mailing address25523 Van Dyke Ave, Center Line, MI 48015-1824

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