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General NPI Number Information
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NPI Number | 1720697063
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Entity Type | Organization
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Legal Business Name | OAKLAND ORTHODONTICS
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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 | 2789 ROCHESTER RD
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City | TROY
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State | MI
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Zip | 48083-1920
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Country | US
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Telephone | 248-824-3097
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Fax |
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Provider Business Mailing Address
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Address Line | 4781 AVONDALE TER
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-3603
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Country | US
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Telephone | 248-824-3097
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | ARCHANA DHAWAN
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Credential | MS ( ORTHODONTICS)
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Telephone | 248-824-3097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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