# ASSOCIATED DENTISTS PC

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

## Provider details

- **NPI number:** 1366518185
- **Authorized official:** NIZAR NAUM MANSOUR DDS MS (PRESIDENT)
- **Authorized official phone:** (248) 628-3700

## Contact information

- **Practice address:** 129 S WASHINGTON ST, OXFORD, MI 48371
- **Practice address phone:** (248) 628-3700
- **Mailing address:** 129 S WASHINGTON ST, OXFORD, MI 48371
- **Mailing address phone:** (248) 628-3700
- **Mailing address fax:** (248) 628-4374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 29012608 | MI | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12608 | BLUE CROSS | — |