Healthcare Provider Details

I. General information

NPI: 1760396717
Provider Name (Legal Business Name): ADVANCED DENTAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28535 ORCHARD LAKE RD STE 400
FARMINGTON HILLS MI
48334-2918
US

IV. Provider business mailing address

28535 ORCHARD LAKE RD STE 400
FARMINGTON HILLS MI
48334-2918
US

V. Phone/Fax

Practice location:
  • Phone: 248-848-1126
  • Fax: 248-848-1190
Mailing address:
  • Phone: 248-848-1126
  • Fax: 248-848-1190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: TOSHA PATEL
Title or Position: OWNER
Credential:
Phone: 734-709-6861