Individual
MARIAM TAHIR SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BDS, MS
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(763) 936-3940
(734) 936-3923
Mailing address
18500 COUNTY ROAD 6, PLYMOUTH, MN 55447-2531
(612) 735-0950
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2952000810
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
S-167
MN
1223X2210X
Orofacial Pain Dentistry
Primary
2952000810
MI
1223X2210X
Orofacial Pain Dentistry
S167
MN
Other
Enumeration date
03/30/2021
Last updated
03/28/2023
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