Professional Dental Alliance of Michigan, LLC

NPI #1912389842 in Hazel Park, Michigan

Provider Information

NPI Number: 1912389842
Entity Type: Organization
Organization Name: Professional Dental Alliance of Michigan, LLC
Primary Specialty: Dentist
Enumeration Date: Jun 27, 2015
Last Updated: Jun 27, 2015

Practice Location

Address: 23528 JOHN R RD
City: Hazel Park
State: Michigan
ZIP Code: 48030-1409
Phone: (248) 397-1165

Authorized Official

Name: DR. SHAKIB HALABU
Title: DENTIST
Phone: (248) 397-1165

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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