Individual
MANAL ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4819 HAGGERTY RD, WEST BLOOMFIELD, MI 48323-3901
(248) 863-9109
Mailing address
4925 ROSALIE ST, DEARBORN, MI 48126-2830
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020744
MI
Other
Enumeration date
07/10/2012
Last updated
12/10/2021
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