# RENEWAL FAMILY DENTAL PLLC

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

## Provider details

- **NPI number:** 1497347686
- **Authorized official:** DR. SABAH LILLIAN GAGNON-SALEEBY DDS (DENTIST)
- **Authorized official phone:** (313) 213-2505

## Contact information

- **Practice address:** 22190 GARRISON ST STE 201, DEARBORN, MI 48124-2235
- **Practice address phone:** (313) 277-8900
- **Mailing address:** 600 RIDGEMONT AVE, DEARBORN, MI 48124-1221
- **Mailing address phone:** (313) 213-2505

## Taxonomy

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

## Other

- **Enumeration date:** 02/09/2021
- **Last updated:** 02/09/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1982087953 | OWNER OF PRACTICE | MI |