Provider Demographics
NPI:1942950894
Name:DOCTORS K&R HL PLLC
Entity Type:Organization
Organization Name:DOCTORS K&R HL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-673-6767
Mailing Address - Street 1:51263 PLYMOUTH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6392
Mailing Address - Country:US
Mailing Address - Phone:313-673-6767
Mailing Address - Fax:
Practice Address - Street 1:3185 W HOUGHTON LAKE DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-8242
Practice Address - Country:US
Practice Address - Phone:313-673-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental