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General NPI Number Information
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NPI Number | 1043195449
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Entity Type | Individual
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Provider Name | ROGER SALEH SHABAN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 38000 ANN ARBOR TRL
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City | LIVONIA
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State | MI
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Zip | 48150-2453
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Country | US
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Telephone | 734-591-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 290 ELMGROVE DRIVE
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City | WINDSOR
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State | ON
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Zip | N8N 3S4
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Country | CA
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901018514
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License Number State | MI
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