# MY FAMILY DENTAL PLLC

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

## Provider details

- **NPI number:** 1548612872
- **Authorized official:** NABIH KIZY (MANAGER)
- **Authorized official phone:** (586) 939-7788

## Contact information

- **Practice address:** 626 N CROOKS RD, CLAWSON, MI 48017-1310
- **Practice address phone:** (586) 939-7788
- **Practice address fax:** (586) 303-0053
- **Mailing address:** 18800 W 10 MILE RD, SOUTHFIELD, MI 48075-2654
- **Mailing address phone:** (586) 939-7788
- **Mailing address fax:** (586) 303-0053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901018613 | MI | Yes |

## Other

- **Enumeration date:** 07/11/2016
- **Last updated:** 07/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0 | 0 | MI |