Healthcare Provider Details

I. General information

NPI: 1073146726
Provider Name (Legal Business Name): FOREVER SMILES ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4227 S CANTON CENTER RD
CANTON MI
48188-2448
US

IV. Provider business mailing address

4227 S CANTON CENTER RD
CANTON MI
48188-2448
US

V. Phone/Fax

Practice location:
  • Phone: 734-397-6999
  • Fax:
Mailing address:
  • Phone: 734-397-6999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RITU SINGH
Title or Position: SOLE PROPRIETOR
Credential: DMD, MS
Phone: 734-397-6999