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General NPI Number Information
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NPI Number | 1992459556
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Entity Type | Organization
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Legal Business Name | ROCHESTER HILLS PROFESSIONALS LLC
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 2064 W AUBURN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3628
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Country | US
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Telephone | 248-853-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 EXCELSIOR DR
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City | MADISON
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State | WI
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Zip | 53717-1900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CONTROLLER
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Name | MITCH WEILAND
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Credential |
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Telephone | 608-343-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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