Organization Name: | YASER SHAHEEN D.M.D PLLC |
NPI Number: | 1033565809 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YASER SHAHEEN (PRESIDENT) |
Mailing Address: | 27115 Northmore St Dearborn Heights |
State: | MI US |
Postal Code: | 481273643 |
Phone Number: | 3139185188 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2016 |
NPI Last Update Date: | 05/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 2901021613 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |