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General NPI Number Information
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NPI Number | 1730922113
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Entity Type | Individual
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Provider Name | ALI ZAINI
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Gender | Male
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 5705 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48209-2157
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Country | US
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Telephone | 313-842-3771
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Fax |
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Provider Business Mailing Address
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Address Line | 6355 HARTWELL ST
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City | DEARBORN
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State | MI
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Zip | 48126-2272
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Country | US
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Telephone | 504-535-0290
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901602062
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License Number State | MI
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