Provider Demographics
NPI:1629454632
Name:ASSAD, AMIR NAFIE (DMD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:NAFIE
Last Name:ASSAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25900 W 6 MILE RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2213
Mailing Address - Country:US
Mailing Address - Phone:313-533-8150
Mailing Address - Fax:
Practice Address - Street 1:25900 W 6 MILE RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2213
Practice Address - Country:US
Practice Address - Phone:313-533-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040476122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist