Maryam Ruby Kishta-derani D.D.S.

NPI 1407049810 - Dentist - 122300000X

NPI Details
NPI 1407049810
Gender Female
Enumeration Date 08/20/2007
Last Updated 08/20/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2815 S PENNSYLVANIA AVE
SUITE 203
LANSING MI, 48910-3496, US
Phone (517) 272-4150
Fax
Business Location
6633 WESTWOOD CT
WEST BLOOMFIELD MI, 48322-1371, US
Phone (248) 408-3136
Fax
Toxanomy
Taxonomy Code 122300000X
License State Michigan
License Number 2901019672
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According to our database, Dr. Maryam Ruby Kishta-derani D.D.S. NPI is 1407049810, taxonomy code is 122300000X and license number is 2901019672, license state is located at Michigan. Maryam Ruby Kishta-derani D.D.S. physically located at 2815 S Pennsylvania Ave, Lansing MI, 48910-3496. NPI Number Maryam Ruby Kishta-derani D.D.S. has the Individual type.

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1407049810 NPI number is provided on an as is basis without warranty of any kind. 1407049810 is maintained by the National Plan & Provider Enumeration System. The contents of Maryam Ruby Kishta-derani D.D.S. are for informational purposes only.