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Organization

DIVINE FAMILY DENISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDI ABDEL-HAMEED (RECEPTIONIST)
(586) 445-2990
Entity
Organization

Contact information

Practice address
27845 GRATIOT AVE, ROSEVILLE, MI 48066-4848
(586) 445-2990
Mailing address
27845 GRATIOT AVE, ROSEVILLE, MI 48066-4848
(586) 445-2990

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223P0300X
Periodontics
124Q00000X
Dental Hygienist
126800000X
Dental Assistant

Other

Enumeration date
01/29/2015
Last updated
01/29/2015
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