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General NPI Number Information
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NPI Number | 1982849683
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Entity Type | Organization
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Legal Business Name | SOUTHFIELD DENTAL CENTER PC
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 17727 W. TEN MILE RD.
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 248-552-8200
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Fax | 248-552-9955
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Provider Business Mailing Address
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Address Line | 17727 W. TEN MILE RD.
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 248-552-8200
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Fax | 248-552-9955
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Authorized Official
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Title or Position | PRES
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Name | DR. SAAD JOHN MURAD
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Credential | D.D.S.
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Telephone | 248-552-8200
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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 | MI 016371
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License Number State | MI
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