Individual
ANDREW ATISHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6700
Mailing address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5315071893
MI
Other
Enumeration date
06/25/2015
Last updated
04/26/2016
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