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General NPI Number Information
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NPI Number | 1750631628
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Entity Type | Organization
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Legal Business Name | FUTURE IMAGE DENTAL PC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 39595 W 10 MILE RD STE 106
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City | NOVI
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State | MI
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Zip | 48375-2948
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Country | US
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Telephone | 248-477-7230
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Fax |
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Provider Business Mailing Address
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Address Line | 39595 W 10 MILE RD STE 106
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City | NOVI
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State | MI
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Zip | 48375-2948
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Country | US
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Telephone | 248-477-7230
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NAWAR ATHEER KARMO
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Credential | D.D.S
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Telephone | 248-310-6955
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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 | 2901019986
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License Number State | MI
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