Organization
REGENTS OF THE UNIVERSITY OF MICHIGAN ORAL PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHA J. D'SILVA DDS PHS (LABORATORY DIRECTOR)
(734) 764-1543
Entity
Organization
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1543
(734) 764-2469
Mailing address
4251 PLYMOUTH RD, BUILDING 3 SUITE 2400, ANN ARBOR, MI 48109-2789
(734) 647-8091
(734) 647-8090
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027740
MIDWEST HEALTH
MI
01
—
190H110650
BCBS OF MI MED SURGICAL
MI
01
—
DD81014
M-CARE
MI
01
—
QMXPR0013422
MOLINA HEALTHCARE OF MI
MI
01
—
XX20091
HEALTH PLUS OF MI
MI
Enumeration date
03/20/2007
Last updated
02/04/2014
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