MEDICARE: HEIGHTS DENTAL CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1548944390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIGHTS DENTAL CARE PLLC

Provider Business Mailing Address
First Line	:	4929 S TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-2027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4929 S TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-2027
Country	:	US
Telephone Number	:	313-909-1136
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MAHMOUD FARHAT
Credential	:	DDS
Telephone Number	:	313-909-1136

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	06/12/2023

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