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General NPI Number Information
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NPI Number | 1750514162
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Entity Type | Organization
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Legal Business Name | NOVI DENTAL CARE PC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 21580 NOVI RD SUITE 250
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City | NOVI
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State | MI
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Zip | 48375-5600
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Country | US
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Telephone | 248-880-3568
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Fax |
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Provider Business Mailing Address
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Address Line | 25821 LOCHMOOR LN
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City | NOVI
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State | MI
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Zip | 48374-2330
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Country | US
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Telephone | 248-880-3568
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYUNGHO CHOI
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Credential | DDS
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Telephone | 248-880-3568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901019027
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License Number State | MI
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