Individual
DR. NICOLE JULIA SIARA-OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
38110 MICHIGAN AVE, WAYNE, MI 48184-2842
(734) 728-1705
(734) 728-1762
Mailing address
4232 THOMAS AVE, BERKLEY, MI 48072-3170
(248) 298-6499
(248) 246-6587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901018908
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901018908
MI
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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