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General NPI Number Information
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NPI Number | 1609146265
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Entity Type | Organization
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Legal Business Name | RUDY N HAJJI DDS PC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 17272 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3151
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Country | US
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Telephone | 734-266-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 17272 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3151
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Country | US
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Telephone | 734-266-2050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RUDY HAJJI
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Credential | DDS
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Telephone | 735-266-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2901017440
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License Number State | MI
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