Healthcare Provider Details

I. General information

NPI: 1831277904
Provider Name (Legal Business Name): ROBERT NICHOLAS CHAMES D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39595 TEN MILE 107
NOVI MI
48375-2948
US

IV. Provider business mailing address

39595 TEN MILE 107
NOVI MI
48375-2948
US

V. Phone/Fax

Practice location:
  • Phone: 248-476-0800
  • Fax: 248-476-5531
Mailing address:
  • Phone: 248-476-0800
  • Fax: 248-476-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16473
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: