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General NPI Number Information
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NPI Number | 1174880736
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Entity Type | Organization
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Legal Business Name | OAKWOOD DENTISTS P.L.L.C.
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 4700 SCHAEFER RD #109
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City | DEARBORN
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State | MI
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Zip | 48126-3698
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Country | US
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Telephone | 313-945-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 SCHAEFER RD #109
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City | DEARBORN
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State | MI
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Zip | 48126-3698
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Country | US
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Telephone | 313-945-8900
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | STEVEN JAFFE
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Credential | D.D.S.
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Telephone | 248-672-0425
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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 | 2901020093
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License Number State | MI
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