Eastside Family Dentistry
Dentist, General Practice in Shelby Township, MI. Organization (NPI-2).
NPI number1649595232
StatusActive
Last updated in NPPESApr 7, 2010
Details
- NPI
- 1649595232
- Entity type
- Organization (NPI-2)
- Legal business name
- Eastside Family Dentistry
- Organization subpart
- No
- Enumeration date
- Apr 7, 2010
- Last updated
- Apr 7, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 2901016598 | MI | Yes |
Practice location
48926 Schoenherr Rd.Shelby Township, MI 48315
Phone 586-566-5660
Mailing address
48926 Schoenherr Rd.Shelby Township, MI 48315
Phone 586-566-5660
Authorized official
Fadi George Keyorkgy
Owner
5865665660
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