Healthcare Provider Details

I. General information

NPI: 1790199743
Provider Name (Legal Business Name): SHUYAN ROFE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 W. EMMETT ST.
BATTLE CREEK MI
49037
US

IV. Provider business mailing address

181 W. EMMETT STREET
BATTLE CREEK MI
49037
US

V. Phone/Fax

Practice location:
  • Phone: 269-966-2600
  • Fax: 269-965-4773
Mailing address:
  • Phone: 269-966-2600
  • Fax: 269-965-4773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901021312
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: