Healthcare Provider Details

I. General information

NPI: 1538086962
Provider Name (Legal Business Name): AVIAN FRANCIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59041 GRATIOT AVE
NEW HAVEN MI
48048-2057
US

IV. Provider business mailing address

51336 TIMES SQUARE DR
SHELBY TOWNSHIP MI
48315-2456
US

V. Phone/Fax

Practice location:
  • Phone: 586-749-3333
  • Fax:
Mailing address:
  • Phone: 586-749-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603179
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: