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General NPI Number Information
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NPI Number | 1235161860
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Entity Type | Individual
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Provider Name | MAYANK D VORA DDS
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6251 GRAND RIVER RD STE 600
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City | BRIGHTON
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State | MI
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Zip | 48114-5321
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Country | US
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Telephone | 517-552-2000
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Fax | 175-552-2885
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Provider Business Mailing Address
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Address Line | 6251 GRAND RIVER RD STE 600
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City | BRIGHTON
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State | MI
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Zip | 48114-5321
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Country | US
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Telephone | 517-552-2000
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Fax | 175-552-2885
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2901018590
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License Number State | MI
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