Healthcare Provider Details

I. General information

NPI: 1841957107
Provider Name (Legal Business Name): TRINITY FAMILY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 N SAGINAW RD
MOUNT MORRIS MI
48458-1648
US

IV. Provider business mailing address

8326 N SAGINAW RD
MOUNT MORRIS MI
48458-1648
US

V. Phone/Fax

Practice location:
  • Phone: 810-687-5040
  • Fax: 810-687-5130
Mailing address:
  • Phone: 810-687-5040
  • Fax: 810-687-5130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS ELIAS HADDAD
Title or Position: DENTIST
Credential: DDS
Phone: 810-687-5040