# A1 FAMILY DENTISTRY OF LICOLN PARK,PLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1366826182
- **Authorized official:** DR. ANEEL KAURR RANDHAWA DDS (OWNER)
- **Authorized official phone:** (586) 226-0638

## Contact information

- **Practice address:** 3830 FORT ST, LINCOLN PARK, MI 48146-4107
- **Practice address phone:** (586) 226-0638
- **Mailing address:** 50481 KOSS DR, MACOMB, MI 48044-6320
- **Mailing address phone:** (586) 226-0638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901019199 | MI | Yes |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 07/10/2015