Individual
MARIA AL ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6685
Mailing address
50136 WOODFORD DR, CANTON, MI 48188-2863
(857) 272-2572
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901601028
MI
1223P0221X
Pediatric Dentistry
DF11463
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2014
Last updated
09/02/2021
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