Individual
MOHAMMAD T SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
23800 ORCHARD LAKE RD STE 106, FARMINGTON HILLS, MI 48336-2561
(248) 755-5700
Mailing address
3654 WILTSHIRE, CANTON, MI 48188-2956
(734) 262-0909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901602365
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2023
Last updated
09/24/2024
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