Provider Demographics
NPI:1922185891
Name:RAFIQ, AYESHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:RAFIQ
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 1:24625 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48780
Mailing Address - Country:US
Mailing Address - Phone:313-299-3282
Mailing Address - Fax:
Practice Address - Street 1:530 S MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161
Practice Address - Country:US
Practice Address - Phone:734-242-1500
Practice Address - Fax:734-242-1346
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist