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General NPI Number Information
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NPI Number | 1992762454
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY DENTISTRY & IMPLANTOLOGY, P.C.
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5645 N SHELDON RD
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City | CANTON
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State | MI
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Zip | 48187-3150
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Country | US
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Telephone | 734-455-0095
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Fax | 734-455-0099
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Provider Business Mailing Address
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Address Line | 5645 N SHELDON RD
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City | CANTON
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State | MI
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Zip | 48187-3150
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Country | US
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Telephone | 734-455-0095
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Fax | 734-455-0099
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NADER BAZZI
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Credential | D.D.S.
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Telephone | 734-455-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2901017182
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License Number State | MI
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