Individual
LEEN KHATIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10460 PELHAM RD, TAYLOR, MI 48180-3828
(313) 299-9700
Mailing address
4466 AUGUSTA CT, ANN ARBOR, MI 48108-9789
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901022956
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901022956APP19
MI
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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