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General NPI Number Information
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NPI Number | 1003255167
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Entity Type | Individual
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Provider Name | AARON MICHAEL HAVENS D.M.D., M.S.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 64845 VAN DYKE RD
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City | WASHINGTON
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State | MI
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Zip | 48095-2836
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Country | US
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Telephone | 586-752-3504
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Fax |
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Provider Business Mailing Address
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Address Line | 64845 VAN DYKE RD
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City | WASHINGTON
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State | MI
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Zip | 48095-2836
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Country | US
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Telephone | 586-752-3504
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901020266
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901020266
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License Number State | MI
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