Individual
ABRAHAM LAWRENCE AZZOUZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
24366 GRAND RIVER AVE, SUITE 111, DETROIT, MI 48219-3063
(313) 535-2273
(313) 535-5212
Mailing address
24366 GRAND RIVER AVE, SUITE 111, DETROIT, MI 48219-3063
(313) 535-2273
(313) 535-5212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901015675
MI
124Q00000X
Dental Hygienist
2902014138
MI
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15675
DELTA
MI
05
—
3197750
—
MI
01
—
873745
UNITED CONCORDIA
—
01
—
D800185
BLUE CROSS BLUE SHEILD
MI
Enumeration date
05/03/2006
Last updated
09/11/2025
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