Individual
SUHEIL M BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
300 E LONG LAKE, SUITE 290, BLOOMFIELD HILLS, MI 48304
(248) 647-0516
(248) 433-1664
Mailing address
5900 GEDDES RD, YPSILANTI, MI 48198-9556
(734) 485-3994
(810) 732-4704
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
16909
MI
1223P0300X
Periodontics
Primary
2901016909
MI
Other
Enumeration date
11/16/2006
Last updated
10/01/2021
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