Provider Demographics
NPI:1336404979
Name:ABOONA, FAITH M (DDS)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:M
Last Name:ABOONA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49202 E WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-1850
Mailing Address - Country:US
Mailing Address - Phone:248-854-0618
Mailing Address - Fax:
Practice Address - Street 1:64845 VAN DYKE RD
Practice Address - Street 2:#3
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48095-2836
Practice Address - Country:US
Practice Address - Phone:586-752-6596
Practice Address - Fax:586-752-5471
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020756122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist