Provider Demographics
NPI:1730673583
Name:MN KIZY DDS PC
Entity Type:Organization
Organization Name:MN KIZY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NABIH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-939-7788
Mailing Address - Street 1:13205 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-6302
Mailing Address - Country:US
Mailing Address - Phone:586-939-7788
Mailing Address - Fax:
Practice Address - Street 1:G3535 BEECHER RD STE 1
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-2700
Practice Address - Country:US
Practice Address - Phone:586-709-4210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty