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General NPI Number Information
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NPI Number | 1659997716
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Entity Type | Organization
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Legal Business Name | MICHIGAN FAMILY DENTAL CARE, PLLC
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 26699 W 12 MILE RD STE 110
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1578
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Country | US
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Telephone | 248-306-8288
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Fax | 248-306-8289
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Provider Business Mailing Address
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Address Line | 401 COMMERCE DR STE 108
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-2724
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Country | US
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Telephone | 248-306-8288
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Fax | 248-306-8289
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Authorized Official
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Title or Position | OWNER
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Name | DR. AHMAD YOSIF
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Credential | DDS
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Telephone | 909-967-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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