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General NPI Number Information
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NPI Number | 1518827252
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Entity Type | Organization
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Legal Business Name | OXFORD LAKES PERIODONTICS
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 950 S LAPEER RD
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City | OXFORD
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State | MI
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Zip | 48371-5041
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Country | US
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Telephone | 248-313-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 950 S LAPEER RD
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City | OXFORD
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State | MI
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Zip | 48371-5041
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Country | US
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Telephone | 248-313-8882
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Fax |
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Authorized Official
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Title or Position | DENTAL BILLER
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Name | RITA SHAOONI
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Credential |
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Telephone | 586-925-3154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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