Provider Demographics
NPI:1427352178
Name:CANTON FAMILY DENTISTRY
Entity type:Organization
Organization Name:CANTON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAKIB
Authorized Official - Middle Name:
Authorized Official - Last Name:HALABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-231-5550
Mailing Address - Street 1:44968 FORD ROAD
Mailing Address - Street 2:SUITE R
Mailing Address - City:CANTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48187
Mailing Address - Country:US
Mailing Address - Phone:248-231-5550
Mailing Address - Fax:248-855-3824
Practice Address - Street 1:44968 FORD ROAD
Practice Address - Street 2:SUITE R
Practice Address - City:CANTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48187
Practice Address - Country:US
Practice Address - Phone:248-231-5550
Practice Address - Fax:248-855-3824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty