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General NPI Number Information
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NPI Number | 1952936122
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Entity Type | Organization
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Legal Business Name | WEN-CHI TAKADA DDS,PC
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 43155 MAIN ST STE 2312
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City | NOVI
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State | MI
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Zip | 48375-1781
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Country | US
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Telephone | 248-344-1000
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Fax | 248-349-3995
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Provider Business Mailing Address
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Address Line | 43155 MAIN ST STE 2312
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City | NOVI
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State | MI
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Zip | 48375-1781
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Country | US
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Telephone | 248-344-1000
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Fax | 248-349-3995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WEN-CHI TAKADA
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Credential | DDS
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Telephone | 248-344-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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