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General NPI Number Information
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NPI Number | 1821378621
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Entity Type | Organization
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Legal Business Name | UNIVERSTIY ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 214 W MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1327
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Country | US
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Telephone | 734-429-5433
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Fax | 734-429-5033
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Provider Business Mailing Address
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Address Line | 214 W MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1327
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Country | US
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Telephone | 734-429-5433
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Fax | 734-429-5033
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANDRE HAERIAN
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Credential | DDS,MS,FRCD(C),PHD
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Telephone | 734-429-5433
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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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