Individual
DR. ANDREA SUSAN VIVIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, RPH
Contact information
Practice address
50475 FELLOWS HILL DR, PLYMOUTH, MI 48170-6351
(734) 453-7948
Mailing address
50475 FELLOWS HILL DR, PLYMOUTH, MI 48170-6351
(734) 453-7948
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014159
MI
183500000X
Pharmacist
5302022074
MI
Other
Enumeration date
08/14/2006
Last updated
07/23/2016
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