Provider Demographics
NPI:1962059782
Name:CARE DENTAL FAMILY PLLC
Entity type:Organization
Organization Name:CARE DENTAL FAMILY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-945-9977
Mailing Address - Street 1:5237 OAKMAN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4045
Mailing Address - Country:US
Mailing Address - Phone:313-945-9977
Mailing Address - Fax:313-945-9970
Practice Address - Street 1:5237 OAKMAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4045
Practice Address - Country:US
Practice Address - Phone:313-945-9977
Practice Address - Fax:313-945-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty