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General NPI Number Information
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NPI Number | 1447836606
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Entity Type | Organization
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Legal Business Name | NOVI FAMILY DENTIST, PLLC
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 45005 W PONTIAC TRL
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City | NOVI
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State | MI
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Zip | 48377-1252
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Country | US
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Telephone | 248-669-1040
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Fax |
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Provider Business Mailing Address
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Address Line | 905 W EISENHOWER CIR STE 105
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City | ANN ARBOR
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State | MI
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Zip | 48103-6400
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Country | US
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Telephone | 734-846-1788
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WEI WANG
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Credential | DMD, PHD, FAGD
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Telephone | 734-846-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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