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General NPI Number Information
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NPI Number | 1487386561
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Entity Type | Individual
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Provider Name | SALLEN AOGHIZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 19931 W 12 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2591
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Country | US
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Telephone | 248-274-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 16150 CLARKSON DR APT 12
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City | FRASER
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State | MI
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Zip | 48026-5251
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Country | US
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Telephone | 586-277-7859
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901601236
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License Number State | MI
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