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General NPI Number Information
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NPI Number | 1891255964
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Entity Type | Organization
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Legal Business Name | ALI ISMAIL DDS PLLC
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 03/23/2019
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Provider Practice Location Address
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Address Line | 8701 N SHELDON RD
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City | CANTON
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State | MI
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Zip | 48187-1970
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Country | US
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Telephone | 734-451-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 41920 WOLFE PASS
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City | NOVI
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State | MI
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Zip | 48377-2867
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Country | US
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Telephone | 248-520-0456
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ALI ISMAIL
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Credential | DDS
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Telephone | 248-520-0456
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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 |
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License Number State |
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