# HAVEN DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184416828
- **Authorized official:** ELIZABETH KOSSAK DDS (DENTIST/PRACTICE OWNER)
- **Authorized official phone:** (313) 580-3258

## Contact information

- **Practice address:** 19535 MACK AVE, GROSSE POINTE WOODS, MI 48236-2836
- **Practice address phone:** (313) 580-3258
- **Mailing address:** 295 CLOVERLY RD, GROSSE POINTE FARMS, MI 48236-3303
- **Mailing address phone:** (313) 580-3258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2025
- **Last updated:** 05/19/2025