Azzouz, Abraham Lawrence

Azzouz, Abraham Lawrence is an individual health care provider with primary practice located at 24366 Grand River Ave Suite 111, Detroit MI 48219-3063. He recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dental Hygienist, Dental Providers / Dental Assistant. Dental Providers / General Practice is his primary health care specialty. Azzouz, Abraham Lawrence can be contacted via phone (313) 535-2273.

Contact Information

Primary practice address
24366 Grand River Ave Suite 111 Detroit MI 48219-3063
Phone: (313) 535-2273
Fax: (313) 535-5212
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901015675 Michigan
Dental Providers / Dental Hygienist 124Q00000X 2902014138 Michigan
Dental Providers / Dental Assistant 126800000X

Profile Details

NPI number 1710945308
LBN Legal business name Azzouz, Abraham Lawrence
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710945308 NPPES
Michigan Other 15675 DELTA
Michigan MEDICAID 3197750 DELTA
Michigan Other 873745 DELTA
Michigan Other D800185 DELTA

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