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General NPI Number Information
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NPI Number | 1174719306
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Entity Type | Organization
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Legal Business Name | PLEASANT DENTAL PLLC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 31515 GRATIOT AVE
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City | ROSEVILLE
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State | MI
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Zip | 48066-4528
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Country | US
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Telephone | 586-294-0900
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Fax | 586-294-0903
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Provider Business Mailing Address
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Address Line | 31515 GRATIOT AVE
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City | ROSEVILLE
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State | MI
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Zip | 48066-4528
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Country | US
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Telephone | 586-294-0900
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Fax | 586-294-0903
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADIL J ALBAGHDADI
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Credential | DMD
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Telephone | 586-294-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2901017548
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License Number State | MI
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