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General NPI Number Information
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NPI Number | 1912157199
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Entity Type | Organization
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Legal Business Name | KHALIL & KINAIA D.D.S.,P.C.
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | G3500 FLUSHING RD STE 107E
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City | FLINT
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State | MI
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Zip | 48504-4235
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Country | US
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Telephone | 810-720-0611
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Fax | 810-720-0613
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Provider Business Mailing Address
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Address Line | G3500 FLUSHING RD STE 107E
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City | FLINT
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State | MI
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Zip | 48504-4235
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Country | US
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Telephone | 810-720-0611
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Fax | 810-720-0613
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD M KHALIL
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Credential |
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Telephone | 810-720-0611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17676
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17782
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License Number State | MI
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