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Individual

SUSAN RIZK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD MS

Contact information

Practice address
17550 W 11 MILE RD, LATHRUP VILLAGE, MI 48076-4725
(248) 565-3331
Mailing address
6848 RESERVE RD, WEST BLOOMFIELD, MI 48322-1392

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
14651
MD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901021142
MI

Other

Enumeration date
08/06/2009
Last updated
12/07/2016
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