# EXECUTIVE DENTISTRY DDS PC

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

## Provider details

- **NPI number:** 1598007692
- **Authorized official:** DR. KALIL A ABRAHAM DDS, FAGD, FKOL (OWNER)
- **Authorized official phone:** (313) 914-4440

## Contact information

- **Practice address:** 23044 CHERRY HILL ST, DEARBORN, MI 48124-1066
- **Practice address phone:** (313) 914-4440
- **Mailing address:** 23044 CHERRY HILL ST, DEARBORN, MI 48124-1066
- **Mailing address phone:** (313) 914-4440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 18195 | MI | Yes |

## Other

- **Enumeration date:** 03/27/2013
- **Last updated:** 03/09/2017