# COMMUNITY DENTISTRY PLUS,P,C

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

## Provider details

- **NPI number:** 1689798530
- **Authorized official:** KHAYRI KASSAB (OWNER DENTIST)
- **Authorized official phone:** (248) 790-3738

## Contact information

- **Practice address:** 18161 W 12 MILE RD, SUIT 2, LATHRUP VILLAGE, MI 48076-2662
- **Practice address phone:** (248) 790-3738
- **Practice address fax:** (248) 552-3777
- **Mailing address:** 30480 SHOREHAM ST, SOUTHFIELD, MI 48076-5368
- **Mailing address phone:** (248) 790-3738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 29010109220 | MI | Yes |

## Other

- **Enumeration date:** 03/18/2007
- **Last updated:** 11/06/2007