Provider Demographics
NPI:1043850134
Name:AMAZING DENTAL PLLC
Entity Type:Organization
Organization Name:AMAZING DENTAL PLLC
Other - Org Name:AMAZING DENTAL, YPSILANTI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NAWRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-467-7072
Mailing Address - Street 1:6755 MERRIMAN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2738 WASHTENAW RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1506
Practice Address - Country:US
Practice Address - Phone:734-887-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental