Provider Demographics
NPI:1710241781
Name:BHATIA, RUCHI RAVI (DDS)
Entity Type:Individual
Prefix:
First Name:RUCHI
Middle Name:RAVI
Last Name:BHATIA
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 1:6003 ROLTON CT
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-1435
Mailing Address - Country:US
Mailing Address - Phone:248-470-7428
Mailing Address - Fax:
Practice Address - Street 1:33080 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-1867
Practice Address - Country:US
Practice Address - Phone:586-293-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020740122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist