Provider Demographics
NPI:1134308976
Name:OFOSU-APPIAH, AMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMA
Middle Name:
Last Name:OFOSU-APPIAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20025 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1804
Mailing Address - Country:US
Mailing Address - Phone:313-653-4990
Mailing Address - Fax:313-273-6148
Practice Address - Street 1:20025 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1804
Practice Address - Country:US
Practice Address - Phone:313-653-4990
Practice Address - Fax:313-273-6148
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI15668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2868903Medicaid