Provider Demographics
NPI:1962552596
Name:BISHAI, ROBERT NEAL (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEAL
Last Name:BISHAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3460
Mailing Address - Country:US
Mailing Address - Phone:313-492-6770
Mailing Address - Fax:
Practice Address - Street 1:280 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3460
Practice Address - Country:US
Practice Address - Phone:313-492-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice