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General NPI Number Information
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NPI Number | 1205636347
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Entity Type | Organization
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Legal Business Name | SPEAR DENTAL
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 2885 E LONG LAKE RD STE C
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City | TROY
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State | MI
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Zip | 48085-4100
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Country | US
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Telephone | 313-769-5850
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Fax |
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Provider Business Mailing Address
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Address Line | 2885 E LONG LAKE RD STE C
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City | TROY
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State | MI
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Zip | 48085-4100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | FADI HADDAD
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Credential |
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Telephone | 313-769-5850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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