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General NPI Number Information
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NPI Number | 1720696131
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Entity Type | Organization
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Legal Business Name | TIFFANY DANYAL SHELBY PLLC
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 51863 SCHOENHERR RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2757
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Country | US
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Telephone | 586-731-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 51863 SCHOENHERR RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2757
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Country | US
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Telephone | 586-731-6300
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Fax |
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Authorized Official
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Title or Position | MANAGEMENT
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Name | MEGAN DRUMMOND
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Credential |
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Telephone | 386-283-7165
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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 |
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License Number State |
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