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General NPI Number Information
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NPI Number | 1972975837
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Entity Type | Organization
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Legal Business Name | MAJESTIC DENTIST PLLC
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 19254 NEWBURGH RD
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City | LIVONIA
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State | MI
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Zip | 48152-1027
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Country | US
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Telephone | 734-425-1610
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Fax | 734-425-1335
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Provider Business Mailing Address
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Address Line | 32788 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-6001
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Country | US
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Telephone | 734-425-1610
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Fax | 734-425-1335
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Authorized Official
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Title or Position | OWNER
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Name | ADUL LATIF HASHWI
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Credential | D.D.S.
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Telephone | 734-425-1610
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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 | 17271
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License Number State | MI
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