Healthcare Provider Details

I. General information

NPI: 1851212856
Provider Name (Legal Business Name): SQUARE ROOT ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 E WEST MAPLE RD
WALLED LAKE MI
48390-3571
US

IV. Provider business mailing address

1080 E WEST MAPLE RD
WALLED LAKE MI
48390-3571
US

V. Phone/Fax

Practice location:
  • Phone: 248-955-3636
  • Fax:
Mailing address:
  • Phone: 248-955-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: ZAID HADI
Title or Position: OWNER
Credential: DMD
Phone: 248-797-0959