Organization
WOLVERINE COSMETIC DENTAL L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAHAR BARBAT D.D.S (DOCTOR)
(248) 395-4700
Entity
Organization
Contact information
Practice address
17070 W. 12 MILE RD, C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
(248) 395-4703
Mailing address
17070 W 12 MILE RD, C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
(248) 395-4703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019508
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437252467
—
MI
05
—
1497949945
—
MI
Enumeration date
07/25/2008
Last updated
07/25/2008
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