Organization
EXECUTIVE DENTISTRY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KALIL A ABRAHAM DDS, FAGD, FKOL (OWNER)
(313) 914-4440
Entity
Organization
Contact information
Practice address
23044 CHERRY HILL ST, DEARBORN, MI 48124-1066
(313) 914-4440
Mailing address
23044 CHERRY HILL ST, DEARBORN, MI 48124-1066
(313) 914-4440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18195
MI
Other
Enumeration date
03/27/2013
Last updated
03/09/2017
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