Provider Demographics
NPI:1699413971
Name:PREMIER SMILES
Entity Type:Organization
Organization Name:PREMIER SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RANIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SULIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-298-6008
Mailing Address - Street 1:9824 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3309
Mailing Address - Country:US
Mailing Address - Phone:313-800-5758
Mailing Address - Fax:313-800-5759
Practice Address - Street 1:9824 CONANT ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3309
Practice Address - Country:US
Practice Address - Phone:313-800-5758
Practice Address - Fax:313-800-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901600645OtherSTATE LICENSE