Individual
DR. PRASANNA KUMAR SHIVAPUJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS,MDS,DDS,MS ORTHO
Contact information
Practice address
25979 KELLY RD, ROSEVILLE, MI 48066-4941
(586) 779-3440
(586) 779-0091
Mailing address
25979 KELLY RD, ROSEVILLE, MI 48066-4941
(586) 779-3440
(586) 779-0091
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
14629
MI
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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