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Organization
SMILE FRESH DETROIT PC
Active
Organization
SMILE FRESH DETROIT PC
Active
Other names
SMILE FRESH DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
FAUZI MOHAMMED RAZIUDDIN (OFFICE MANAGER)
(248) 895-6987
Entity
Organization
Contact information
Practice address
7230 GRATIOT AVENUE, DETROIT, MI 48213
(248) 895-6987
Mailing address
1507 THREADNEEDLE ST, BLOOMFIELD HILLS, MI 48304-1020
(248) 895-6987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901021727
MI
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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