Provider Demographics
NPI:1790199743
Name:ROFE, SHUYAN (DDS)
Entity Type:Individual
Prefix:
First Name:SHUYAN
Middle Name:
Last Name:ROFE
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 1:181 W. EMMETT STREET
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037
Mailing Address - Country:US
Mailing Address - Phone:269-966-2600
Mailing Address - Fax:269-965-4773
Practice Address - Street 1:181 W. EMMETT ST.
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037
Practice Address - Country:US
Practice Address - Phone:269-966-2600
Practice Address - Fax:269-965-4773
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021312122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist