Fassel P.c. | |
25721 Goddard Rd Taylor MI 48180-3974 | |
(612) 735-9399 | |
Not Available |
Full Name | Fassel P.c. |
---|---|
Speciality | Dentist |
Location | 25721 Goddard Rd, Taylor, Michigan |
Authorized Official Name and Position | Fatima Siddiqui (PRESIDENT) |
Authorized Official Contact | 6127359399 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Fassel P.c. 49767 Parkside Dr Northville MI 48168-6821 Ph: (612) 735-9399 | Fassel P.c. 25721 Goddard Rd Taylor MI 48180-3974 Ph: (612) 735-9399 |
NPI Number | 1013631902 |
---|---|
Provider Enumeration Date | 10/03/2022 |
Last Update Date | 10/03/2022 |
Medicare PECOS PAC ID | 1254708068 |
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Medicare Enrollment ID | O20221108002935 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013631902 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Provider Name | Fatima Siddiqui |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1366881740 PECOS PAC ID: 2163899972 Enrollment ID: I20221108002970 |
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