Individual
DR. JAVEN R DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17600 W 12 MILE RD, SOUTHFIELD, MI 48076-1910
(248) 569-8770
Mailing address
5460 PONTIAC TRL, ORCHARD LAKE, MI 48323-1564
(954) 732-8923
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600358
MI
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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