Healthcare Provider Details

I. General information

NPI: 1689807133
Provider Name (Legal Business Name): FLINT FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3500 FLUSHING RD
FLINT MI
48504-4235
US

IV. Provider business mailing address

G3500 FLUSHING RD
FLINT MI
48504-4235
US

V. Phone/Fax

Practice location:
  • Phone: 810-720-0611
  • Fax: 810-720-0613
Mailing address:
  • Phone: 810-720-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901019131
License Number StateMI

VIII. Authorized Official

Name: MR. SADEER DAOOD
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 810-720-0611