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General NPI Number Information
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NPI Number | 1194226902
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Entity Type | Organization
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Legal Business Name | K FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 3456 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48092-2511
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Country | US
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Telephone | 586-486-4600
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Fax | 586-486-4624
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Provider Business Mailing Address
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Address Line | 3456 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48092-2511
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Country | US
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Telephone | 586-486-4600
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Fax | 586-486-4624
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Authorized Official
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Title or Position | MANAGER
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Name | SARA TURSHANI
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Credential |
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Telephone | 727-831-5313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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