Provider Demographics
NPI:1811596091
Name:CENTERLINE FAMILY DENTAL
Entity Type:Organization
Organization Name:CENTERLINE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-604-0968
Mailing Address - Street 1:24650 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1321
Mailing Address - Country:US
Mailing Address - Phone:586-757-2136
Mailing Address - Fax:586-757-7332
Practice Address - Street 1:24650 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1321
Practice Address - Country:US
Practice Address - Phone:586-757-2136
Practice Address - Fax:586-757-7332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental