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General NPI Number Information
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NPI Number | 1295163350
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Entity Type | Individual
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Provider Name | AMBREEN YUSAF D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/28/2013
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Last Update Date | 10/28/2013
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Provider Practice Location Address
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Address Line | 5601 S CEDAR ST
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City | LANSING
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State | MI
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Zip | 48911-3810
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Country | US
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Telephone | 517-882-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 20690 MAPLEWOOD CT
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City | RIVERVIEW
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State | MI
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Zip | 48193-7942
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Country | US
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Telephone | 734-560-1907
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901021074
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License Number State | MI
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