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General NPI Number Information
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NPI Number | 1003908955
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Entity Type | Organization
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Legal Business Name | ORCHARD FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23700 ORCHARD LAKE RD SUITE L
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City | FARMINGTON HILLS
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State | MI
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Zip | 48326
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Country | US
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Telephone | 248-471-9750
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Fax | 248-471-9731
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Provider Business Mailing Address
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Address Line | 23700 ORCHARD LAKE RD SUITE L
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City | FARMINGTON HILLS
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State | MI
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Zip | 48326
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Country | US
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Telephone | 248-471-9750
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Fax | 248-471-9731
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Authorized Official
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Title or Position | DENTIST / CEO
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Name | SHARON A CASTRO
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Credential | DDS
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Telephone | 248-471-9730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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