# ASPEN DENTAL OF MICHIGAN PC

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

## Provider details

- **NPI number:** 1285813832
- **Authorized official:** ISAM HAMATI (OWNER)
- **Authorized official phone:** (315) 454-6000

## Contact information

- **Practice address:** 4391 CANAL AVE SW, GRANDVILLE, MI 49418-2680
- **Practice address phone:** (616) 530-3900
- **Mailing address:** 281 SANDERS CREEK PKWY, EAST SYRACUSE, NY 13057-1307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901019539 | MI | Yes |

## Other

- **Enumeration date:** 10/31/2007
- **Last updated:** 10/31/2007