Individual
PREETHA P KANJIRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS MDS
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1543
(734) 764-2469
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1543
(734) 764-2469
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901017325
MI
1223G0001X
General Practice Dentistry
2901017325
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958111510
BCBS OF MI MED SURGICAL
MI
01
—
D173250
BCBS OF MI DENTAL
MI
Enumeration date
03/15/2007
Last updated
05/09/2013
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