# LASER FAMILY DENTAL

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

## Provider details

- **NPI number:** 1194116517
- **Authorized official:** MR. MAZEN DAOUD BISHARA (OFFICE MANAGER)
- **Authorized official phone:** (248) 250-9333

## Contact information

- **Practice address:** 41069 DEQUINDRE RD STE 101, TROY, MI 48085-6730
- **Practice address phone:** (248) 250-9333
- **Practice address fax:** (248) 688-9221
- **Mailing address:** 41069 DEQUINDRE RD STE 101, TROY, MI 48085-6730
- **Mailing address phone:** (248) 250-9333
- **Mailing address fax:** (248) 688-9221

## Taxonomy

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

## Other

- **Enumeration date:** 02/06/2015
- **Last updated:** 02/06/2015