Organization
PERIODONTAL SPECIALISTS OF FLINT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUHEIL M BOUTROS DDS, MS (PRESIDENT)
(810) 695-6444
Entity
Organization
Contact information
Practice address
4252 S LINDEN RD, FLINT, MI 48507-2953
(810) 733-1890
(810) 733-3619
Mailing address
8185 HOLLY RD, SUITE 19, GRAND BLANC, MI 48439-2444
(810) 695-6444
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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