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

Periodontal Specialists of Clarkston

Organization Periodontics · NPI 1548447576

Periodontal Specialists of Clarkston provides Periodontics in Clarkston, Michigan. Licensed in Michigan. Registered with an NPI since 2008.

Licensed in
MI
In the registry since
2008

Practice location Address checks out

6803 Dixie Hwy Ste 1
Clarkston, MI 48346-5101
Phone: (248) 625-1721
Fax: (248) 625-5475
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 16909 (MI)

Record details

NPI number1548447576
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Suheil Boutros — Ceo/President · (810) 695-6444
NPI enumeratedJanuary 22, 2008
Last updated in NPPESApril 25, 2022
Certification dateApril 25, 2022
Mailing address6803 Dixie Hwy Ste 1, Clarkston, MI 48346-5101

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