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Olde Orchard Pediatric Dentistry
Pediatric Dentist in Novi, Michigan
NPI 1265682900

Olde Orchard Pediatric Dentistry is a Pediatric Dentist based in Novi, MI and is specialized in Pediatric Dentistry. Olde Orchard Pediatric Dentistry practices in Novi, MI. The NPI Number for Olde Orchard Pediatric Dentistry is 1265682900 and holds a License No. 2901011539 (Michigan).

The current practice location address for Olde Orchard Pediatric Dentistry is 40105 Grand River Ave Ste 2, Novi, MI and can be reached out via phone at 248-478-3232.

Location: 40105 Grand River Ave Ste 2, Novi, MI, 48375-2170
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1265682900
Provider Name
Olde Orchard Pediatric Dentistry
Credential
Provider Entity Type
Organization
Address
40105 Grand River Ave Ste 2, Novi, MI, 48375-2170
Phone Number
248-478-3232
Fax Number
Provider Enumeration Date
09/30/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2669122 05 MI
2823071 05 MI
institution
Provider Business Practice Location Address Details
Address
40105 Grand River Ave Ste 2
City
Novi
State
Michigan
Zip
48375-2170
Phone Number
248-478-3232
Fax Number
person
Provider Business Mailing Address Details
Address
40105 Grand River Ave Ste 2
City
Novi
State
Michigan
Zip
48375-2170
Phone Number
248-478-3232
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2901011539 (Michigan)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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