Organization
EXTRA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINA YASEEN DDS (DENTIST/OWNER)
(847) 794-3355
Entity
Organization
Contact information
Practice address
8170 23 MILE RD, SHELBY TOWNSHIP, MI 48316-4502
(847) 794-3355
Mailing address
8170 23 MILE RD, SHELBY TOWNSHIP, MI 48316-4502
(847) 794-3355
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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