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Organization
CREATIVE DENTISTRY OF LIVONIA PLLC
Active
Organization
CREATIVE DENTISTRY OF LIVONIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRAJ SHAH DDS (OWNER)
(248) 872-2213
Entity
Organization
Contact information
Practice address
31215 5 MILE RD, LIVONIA, MI 48154-3627
(248) 872-2213
Mailing address
1153 PEMBROKE DR, ROCHESTER HILLS, MI 48307-5756
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194770628
NPI
—
Enumeration date
04/29/2021
Last updated
04/29/2021
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