Amazing Dental Wyandotte PLLC
Clinic/Center, Dental in Wyandotte, MI. Organization (NPI-2).
NPI number1982107710
StatusActive
Last updated in NPPESMar 18, 2018
Details
- NPI
- 1982107710
- Entity type
- Organization (NPI-2)
- Legal business name
- Amazing Dental Wyandotte PLLC
- Organization subpart
- No
- Enumeration date
- Mar 18, 2018
- Last updated
- Mar 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1805 Fort StWyandotte, MI 48192-3545
Phone 248-910-4819
Mailing address
4616 Bennington DrSterling Heights, MI 48310-3113
Authorized official
Shams Hamama
Credentialing
2489104819
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