Individual
DR. BASAM SHAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
22972 LAHSER RD STE 2, SOUTHFIELD, MI 48033-4408
(248) 864-2500
Mailing address
22972 LAHSER RD STE 2, SOUTHFIELD, MI 48033-4408
(248) 864-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901020972
MI
1223P0221X
Pediatric Dentistry
Primary
2901020972
MI
Other
Enumeration date
06/10/2013
Last updated
06/08/2023
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