Individual
RUSSELL S TAICHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1011 N. UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-9952
(734) 763-5503
Mailing address
2215 FULLER RD, ANN ARBOR, MI 48105-2335
(734) 764-9952
(734) 763-5503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016167
MI
1223P0300X
Periodontics
2901016167
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D161670
BCBS OF MICHIGAN
MI
Enumeration date
03/06/2007
Last updated
09/11/2025
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