| Grand River Family Dentistry P.c. | |
|
24366 Grand River Ave Suite 111 Detroit MI 48219-3063 | |
| (313) 535-2273 | |
| (313) 535-5212 |
| Full Name | Grand River Family Dentistry P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 24366 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Abraham Lawrence Azzouz (PRESIDENT DENTIST) |
| Authorized Official Contact | 3135352273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand River Family Dentistry P.c. 24366 Grand River Ave Suite 111 Detroit MI 48219-3063 Ph: (313) 535-2273 | Grand River Family Dentistry P.c. 24366 Grand River Ave Suite 111 Detroit MI 48219-3063 Ph: (313) 535-2273 |
| NPI Number | 1467401141 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467401141 | NPI | - | NPPES |
| BA2373443 | Other | U.S. D.E.A. | |
| 873745 | Other | MI | UNITED CONCORDIA |
| D800185 | Other | MI | BLUE CROSS BLUE SHEILD |
| 3197750 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901015675 (Michigan) | Primary |
Advantage Health Centers Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15400 W Mcnichols Rd, Detroit, MI 48235 Phone: 313-416-6262 Fax: 313-221-8217 | |
Pdc Managemen Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5831 W Vernor Hwy, Detroit, MI 48209 Phone: 313-842-8300 Fax: 313-842-8530 | |
Smiley Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15510 Livernois Ave, Detroit, MI 48238 Phone: 313-863-2800 Fax: 313-863-5054 | |
Allenandallendental & Associates P.c Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10720 W 7 Mile Road, Detroit, MI 48221 Phone: 313-345-4444 Fax: 313-345-4106 | |
Super Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15510 Livernois Ave, Detroit, MI 48238 Phone: 313-863-2800 | |
Megan M Faircloth Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3374 E Jefferson Ave, Detroit, MI 48207 Phone: 313-259-2410 | |
University Otolaryngology Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4201 Saint Antoine St, Suite 5g, Detroit, MI 48201 Phone: 313-745-4656 |