Individual
EMILY SAM KAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20861 E 13 MILE RD, ROSEVILLE, MI 48066-4530
(586) 298-3277
Mailing address
4559 WABEEK FOREST DR, BLOOMFIELD HILLS, MI 48302-1782
(248) 910-5744
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901602266
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2023
Last updated
08/05/2024
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