Andrew Atisha, DMD Valid NPI
Individual provider · Dentist · Detroit, MI
- NPI
- 1932581998
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 5315071893 (MI)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2015-06-25
- Last updated
- 2016-04-26
Practice location
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
(313) 494-6700