Organization
FASSEL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATIMA SIDDIQUI DDS (PRESIDENT)
(612) 735-9399
Entity
Organization
Contact information
Practice address
25721 GODDARD RD, TAYLOR, MI 48180-3974
(612) 735-9399
Mailing address
49767 PARKSIDE DR, NORTHVILLE, MI 48168-6821
(612) 735-9399
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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