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General NPI Number Information
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NPI Number | 1417824863
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Entity Type | Organization
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Legal Business Name | ELITE FAMILY DENTAL
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 42450 W TWELVE MILE RD STE 200
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City | NOVI
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State | MI
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Zip | 48377-3011
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Country | US
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Telephone | 248-348-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 42450 W TWELVE MILE RD STE 200
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City | NOVI
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State | MI
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Zip | 48377-3011
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Country | US
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Telephone | 248-348-8808
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | FARAH NASSER
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Credential | DDS
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Telephone | 734-437-4306
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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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