Provider Demographics
NPI:1891425351
Name:ARBOR BLUE FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:ARBOR BLUE FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-994-5353
Mailing Address - Street 1:6815 PORTSMAN CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2177
Mailing Address - Country:US
Mailing Address - Phone:313-598-4969
Mailing Address - Fax:
Practice Address - Street 1:2340 E STADIUM BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4823
Practice Address - Country:US
Practice Address - Phone:734-994-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty