MEDICARE: LINDSAY FRANCES FUJAWA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901021904	MI

General Provider Information

NPI Number	:	1871911156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY FRANCES FUJAWA DDS

Provider Business Mailing Address
First Line	:	315 2ND ST APT 513
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-4991
Country	:	US
Telephone Number	:	817-223-4551
Fax Number	:

Provider Business Practice Location Address
First Line	:	1657 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2948
Country	:	US
Telephone Number	:	734-335-7270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	07/13/2016

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