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Organization
IMMACULATE DENTAL PLLC
Active
Organization
IMMACULATE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEENA ATISHA DDS (SOLE MEMBER)
(248) 312-8255
Entity
Organization
Contact information
Practice address
4060 HAGGERTY RD, COMMERCE TOWNSHIP, MI 48390-1313
(248) 363-0480
Mailing address
34078 GLOUSTER CIR, FARMINGTON HILLS, MI 48331-4700
(248) 312-8255
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/22/2026
Last updated
08/22/2026
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