Organization
FORD DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZIZ MOUKLED D.D.S. (DENTIST)
(519) 819-7875
Entity
Organization
Contact information
Practice address
5601 SCHAEFER RD STE 101, DEARBORN, MI 48126-4713
(313) 582-4800
Mailing address
5601 SCHAEFER RD STE 101, DEARBORN, MI 48126-4713
(313) 582-4800
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2901021724
MI
Other
Enumeration date
09/07/2015
Last updated
09/07/2015
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