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Organization

OLDE ORCHARD PEDIATRIC DENTISTRY

Active
Other names
Susan H. Carron, D.D.S., M.S.
Organization subpart
No

Provider details

NPI number
Authorized official
DAPHNE WEST (ASSISTANT OFFICE MANAGER)
(248) 478-3232
Entity
Organization

Contact information

Practice address
40105 GRAND RIVER AVE STE 2, NOVI, MI 48375-2170
(248) 478-3232
Mailing address
40105 GRAND RIVER AVE STE 2, NOVI, MI 48375-2170
(248) 478-3232

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901011539
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2669122
MI
05
2823071
MI
Enumeration date
09/30/2008
Last updated
09/30/2008
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