Organization
ASPEN DENTAL OF MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAM HAMATI (OWNER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
4391 CANAL AVE SW, GRANDVILLE, MI 49418-2680
(616) 530-3900
Mailing address
281 SANDERS CREEK PKWY, EAST SYRACUSE, NY 13057-1307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901019539
MI
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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