Organization
ORTHODONTICS CENTER OF NOVI, PC
Active
Organization
ORTHODONTICS CENTER OF NOVI, PC
Active
Other names
Siddiqui Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAMNOON SIDDIQUI (PRESIDENT)
(313) 565-0880
Entity
Organization
Contact information
Practice address
27250 WIXOM RD STE B, NOVI, MI 48374-1116
(313) 565-0880
Mailing address
2211 MONROE ST, DEARBORN, MI 48124-3007
(313) 565-0880
(313) 565-2305
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336225713
—
MI
Enumeration date
06/12/2019
Last updated
06/12/2019
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