Healthcare Provider Details

I. General information

NPI: 1083385629
Provider Name (Legal Business Name): FELIPE NOR DDS, MS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE RM 2029C
ANN ARBOR MI
48109-1078
US

IV. Provider business mailing address

1011 N UNIVERSITY AVE RM 2029C
ANN ARBOR MI
48109-1078
US

V. Phone/Fax

Practice location:
  • Phone: 734-730-9828
  • Fax:
Mailing address:
  • Phone: 734-763-1853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number2901602060
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: