Healthcare Provider Details

I. General information

NPI: 1740106269
Provider Name (Legal Business Name): MICHIGAN PEDIATRIC SURGERY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28815 8 MILE RD
LIVONIA MI
48152-2052
US

IV. Provider business mailing address

28815 8 MILE RD
LIVONIA MI
48152-2052
US

V. Phone/Fax

Practice location:
  • Phone: 313-701-4723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HASSAN OUEIS
Title or Position: DENTAL DIRECTOR
Credential: DDS
Phone: 313-404-1061