Individual
RAJIVA TIRTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1140 S BELSAY RD, SUITE A, BURTON, MI 48509-1909
(810) 744-0433
(810) 744-2257
Mailing address
PO BOX 90459, BURTON, MI 48509-0459
(810) 744-0433
(810) 744-2257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901013544
MI
1223G0001X
General Practice Dentistry
DN9743
FL
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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