Individual
DR. ELISA M. GHEZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6010 W MAPLE RD, SUITE 210, WEST BLOOMFIELD, MI 48322-4406
(248) 932-8980
Mailing address
25853 COBBLERS LN, SOUTH LYON, MI 48178-1572
(248) 486-8912
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016807
MI
1223G0001X
General Practice Dentistry
2901016807
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4125531
—
MI
05
—
4125550
—
MI
Enumeration date
06/18/2006
Last updated
09/11/2025
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