Provider Demographics
NPI:1376294975
Name:NYE DENTAL OF CLINTON PLLC
Entity Type:Organization
Organization Name:NYE DENTAL OF CLINTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ANBAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-374-2070
Mailing Address - Street 1:41840 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1876
Mailing Address - Country:US
Mailing Address - Phone:215-821-5073
Mailing Address - Fax:
Practice Address - Street 1:41840 HAYES RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1876
Practice Address - Country:US
Practice Address - Phone:215-821-5073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental