Provider Demographics
NPI:1093913626
Name:NOORDHOEK, ROSEANNA P (DDS)
Entity Type:Individual
Prefix:
First Name:ROSEANNA
Middle Name:P
Last Name:NOORDHOEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11525 HIGHLAND RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2726
Mailing Address - Country:US
Mailing Address - Phone:810-632-4545
Mailing Address - Fax:810-632-9397
Practice Address - Street 1:11525 HIGHLAND RD
Practice Address - Street 2:SUITE 11
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2726
Practice Address - Country:US
Practice Address - Phone:810-632-4545
Practice Address - Fax:810-632-9397
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2016-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI29010217281223S0112X
PADS0385911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery