Individual
ALI LEILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
22211 GREGORY ST, DEABORN, MI 48124
(313) 437-0051
Mailing address
22211 GREGORY ST, DEABORN, MI 48124
(313) 437-0051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601752
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2023
Last updated
06/14/2023
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