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General NPI Number Information
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NPI Number | 1881562635
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Entity Type | Organization
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Legal Business Name | SHIFT ORTHODONTICS PLLC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 10407 GRAND RIVER RD STE 700
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City | BRIGHTON
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State | MI
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Zip | 48116-6532
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Country | US
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Telephone | 248-459-0639
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Fax |
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Provider Business Mailing Address
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Address Line | 9028 GREEN HICKORY LN
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City | FENTON
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State | MI
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Zip | 48430-9288
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Country | US
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Telephone | 248-459-0639
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. KELLY ANN POHLMAN
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Credential | DDS
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Telephone | 248-459-0639
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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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