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Organization
RENEWAL FAMILY DENTAL PLLC
Active
Organization
RENEWAL FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SABAH LILLIAN GAGNON-SALEEBY DDS (DENTIST)
(313) 213-2505
Entity
Organization
Contact information
Practice address
22190 GARRISON ST STE 201, DEARBORN, MI 48124-2235
(313) 277-8900
Mailing address
600 RIDGEMONT AVE, DEARBORN, MI 48124-1221
(313) 213-2505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982087953
OWNER OF PRACTICE
MI
Enumeration date
02/09/2021
Last updated
02/09/2021
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