Livonia Laser Dentistry | |
31632 Schoolcraft Rd Livonia MI 48150-1819 | |
(734) 425-6920 | |
(734) 425-1541 |
Full Name | Livonia Laser Dentistry |
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Speciality | Dentist - General Practice |
Location | 31632 Schoolcraft Rd, Livonia, Michigan |
Authorized Official Name and Position | Fady Mansour (ADMIN) |
Authorized Official Contact | 7344256920 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Livonia Laser Dentistry 31632 Schoolcraft Rd Livonia MI 48150-1819 Ph: (734) 425-6920 | Livonia Laser Dentistry 31632 Schoolcraft Rd Livonia MI 48150-1819 Ph: (734) 425-6920 |
NPI Number | 1811476955 |
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Provider Enumeration Date | 08/09/2018 |
Last Update Date | 08/09/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811476955 | NPI | - | NPPES |
2901017025 | Other | MI | MICHIGAN PROFESSIONAL LICENSE - DENTISY |
13167481 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 2901017025 (Michigan) | Primary |
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