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General NPI Number Information
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NPI Number | 1104548148
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Entity Type | Individual
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Provider Name | EMAD Y ABDULLA YOUNIS B.D.S
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Gender | Male
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 2700 MARTIN LUTHER KING JR BLVD
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City | DETROIT
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State | MI
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Zip | 48208-2576
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Country | US
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Telephone | 313-494-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 7394 CENTRAL ST APT 2
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City | WESTLAND
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State | MI
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Zip | 48185-2552
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Country | US
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Telephone | 407-617-5222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 2952000800
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 2901601548
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License Number State | MI
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