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General NPI Number Information
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NPI Number | 1740914480
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Entity Type | Organization
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Legal Business Name | CANTON EYE CENTER PLLC
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Dates
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Enumeration Date | 07/09/2022
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 6750 DACOSTA ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2534
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Country | US
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Telephone | 313-522-4481
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Fax | 313-454-4112
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Provider Business Mailing Address
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Address Line | 6750 DACOSTA ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2534
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Country | US
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Telephone | 313-522-4481
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Fax | 313-454-4112
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Authorized Official
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Title or Position | OWNER
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Name | HASSASN SAAB
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Credential | OD
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Telephone | 313-522-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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