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General NPI Number Information
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NPI Number | 1306276787
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Entity Type | Individual
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Provider Name | ARCHANA RAJAN DDS,MS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 3525 MARTIN L. KING BLVD
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City | LANSING
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State | MI
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Zip | 48910
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Country | US
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Telephone | 517-394-1495
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Fax | 517-394-6478
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Provider Business Mailing Address
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Address Line | 5050 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3249
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Country | US
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Telephone | 313-582-8150
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Fax | 313-582-0745
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901020105
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License Number State | MI
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