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General NPI Number Information
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NPI Number | 1851525828
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Entity Type | Organization
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Legal Business Name | NOVI FAMILY DENTAL CENTER PC
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 43410 W 10 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-3172
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Country | US
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Telephone | 248-348-3100
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Fax | 248-348-3252
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Provider Business Mailing Address
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Address Line | 43410 W 10 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-3172
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Country | US
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Telephone | 248-348-3100
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Fax | 248-348-3252
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Authorized Official
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Title or Position | PRESIDENT
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Name | AARON H TUCHKLAPER
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Credential | DDS
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Telephone | 248-348-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 11206
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License Number State | MI
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