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General NPI Number Information
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NPI Number | 1023710746
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Entity Type | Organization
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Legal Business Name | EL-AWADI NORTHVILLE DDS PLLC
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 41620 6 MILE RD STE 101
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City | NORTHVILLE
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State | MI
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Zip | 48168-8528
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Country | US
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Telephone | 248-349-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 41620 SIX MILE RD 101
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City | NORTHVILLE
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State | MI
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Zip | 48168
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Country | US
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Telephone | 248-349-3660
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. WASSIM EL AWADI
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Credential | DDS
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Telephone | 734-377-0264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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