Provider Demographics
NPI:1659171882
Name:NEW FARMINGTON GROUP DENTAL PLLC
Entity type:Organization
Organization Name:NEW FARMINGTON GROUP DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-910-4819
Mailing Address - Street 1:59041 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48048-2057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21635 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-2788
Practice Address - Country:US
Practice Address - Phone:248-910-4819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty