Provider Demographics
NPI:1962134551
Name:PRECISION FAMILY DENTAL OF MI PLLC
Entity type:Organization
Organization Name:PRECISION FAMILY DENTAL OF MI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASMAA
Authorized Official - Middle Name:FATHALLA
Authorized Official - Last Name:ABDEL-SALAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-467-2158
Mailing Address - Street 1:30785 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1804
Mailing Address - Country:US
Mailing Address - Phone:313-467-2158
Mailing Address - Fax:
Practice Address - Street 1:30785 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1804
Practice Address - Country:US
Practice Address - Phone:313-467-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty