Organization
CLEAN SMILE DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAWAL SALAME RDH (OWNER)
(313) 704-2886
Entity
Organization
Contact information
Practice address
2213 N ROSEVERE AVE, DEARBORN, MI 48128-1244
(313) 704-2886
Mailing address
PO BOX 144, DEARBORN HEIGHTS, MI 48127-0144
(313) 704-2886
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902010443
MI
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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