Provider Demographics
NPI:1679038863
Name:EIWAZ DENTAL, PLLC
Entity Type:Organization
Organization Name:EIWAZ DENTAL, PLLC
Other - Org Name:FARMINGTON DENTAL STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARMAD
Authorized Official - Middle Name:RAMZI
Authorized Official - Last Name:EIWAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:248-759-8760
Mailing Address - Street 1:32905 W 12 MILE RD
Mailing Address - Street 2:SUITE 140 BUILDING D
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1982
Mailing Address - Country:US
Mailing Address - Phone:248-516-0004
Mailing Address - Fax:258-522-4626
Practice Address - Street 1:32905 W 12 MILE RD
Practice Address - Street 2:SUITE 140 BUILDING D
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1982
Practice Address - Country:US
Practice Address - Phone:248-516-0004
Practice Address - Fax:258-522-4626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental