# PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC

> 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
- **Other names:** Dental Care of Michigan, Roseville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629440581
- **Authorized official:** SHAKIB HALABU (DENTIST)
- **Authorized official phone:** (248) 397-1165

## Contact information

- **Practice address:** 25631 GRATIOT AVE, ROSEVILLE, MI 48066-4434
- **Practice address phone:** (586) 775-3312
- **Practice address fax:** (586) 775-4780
- **Mailing address:** 11 S MILL ST STE 200, NEW CASTLE, PA 16101-3613
- **Mailing address phone:** (724) 698-2500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901011201 | MI | Yes |

## Other

- **Enumeration date:** 10/30/2015
- **Last updated:** 10/30/2015