Grand River Family Dentistry P.C.
LBN: Grand River Family Dentistry P.C.
Grand River Family Dentistry P.C. is an health care organization with primary practice located at 24366 Grand River Ave Suite 111, Detroit MI 48219-3063. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty.
Grand River Family Dentistry P.C. can be contacted via phone (313) 535-2273, or through Azzouz, Abraham Lawrence 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:
Authorized official contact:
Name: Azzouz, Abraham Lawrence Doctor of Dental Surgery (DDS)
Phone: (313) 535-2273
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2901015675 | Michigan |
Profile Details
| NPI number | 1467401141 |
|---|---|
| LBN Legal business name | Grand River Family Dentistry P.C. |
| DBA Doing business as | |
| Authorized official | Azzouz, Abraham Lawrence Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 9th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467401141 | NPPES |
| Other | BA2373443 | U.S. D.E.A. | |
| Other | 873745 | U.S. D.E.A. | |
| Other | D800185 | U.S. D.E.A. | |
| MEDICAID | 3197750 | U.S. D.E.A. |
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