Individual
LAXMI SUKHTANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18757 HURON RIVER DR, NEW BOSTON, MI 48164-9357
(734) 753-5000
Mailing address
2019 N LOVINGTON DR APT 103, TROY, MI 48083-4372
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901600230
MI
Other
Enumeration date
07/21/2019
Last updated
07/21/2019
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