Individual
ASHWINI SHIRISH BHAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S., M.D.S.
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, THIRD FLOOR, DETROIT, MI 48208-2576
(313) 494-6780
(313) 494-6781
Mailing address
23382 PORTAGE WAY, APT. 2105, NOVI, MI 48375-3297
(909) 557-3009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021409
MI
122300000X
Dentist
A-14265
ZZ
122300000X
Dentist
DE60351086
WA
Other
Enumeration date
03/31/2013
Last updated
10/16/2015
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