Provider Demographics
NPI:1689807133
Name:FLINT FAMILY DENTISTRY
Entity Type:Organization
Organization Name:FLINT FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SADEER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-720-0611
Mailing Address - Street 1:G3500 FLUSHING RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-4235
Mailing Address - Country:US
Mailing Address - Phone:810-720-0611
Mailing Address - Fax:
Practice Address - Street 1:G3500 FLUSHING RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4235
Practice Address - Country:US
Practice Address - Phone:810-720-0611
Practice Address - Fax:810-720-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019131122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty