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General NPI Number Information
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NPI Number | 1215437017
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Entity Type | Organization
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Legal Business Name | FARMINGTON HILLS COMPLETE FAMILY DENTISTRY
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 24100 DRAKE ROAD SUITE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335
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Country | US
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Telephone | 248-478-8880
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Fax | 248-478-9489
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Provider Business Mailing Address
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Address Line | 24100 DRAKE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-3155
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Country | US
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Telephone | 248-478-8880
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Fax | 248-478-9489
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAMI ESSAK
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Credential | DMD
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Telephone | 248-478-8880
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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 | 2901022050
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License Number State | MI
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