Provider Demographics
NPI:1750596037
Name:COMFORT DENTAL GROUP PLLC
Entity type:Organization
Organization Name:COMFORT DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:248-474-6434
Mailing Address - Street 1:33966 W. EIGHT MILE RD. #104
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335
Mailing Address - Country:US
Mailing Address - Phone:248-474-6434
Mailing Address - Fax:248-474-7125
Practice Address - Street 1:33966 W 8 MILE RD STE 104
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-5273
Practice Address - Country:US
Practice Address - Phone:248-474-6434
Practice Address - Fax:248-474-7125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010187781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1841373297OtherAZIZA ASKARI
MI1275581571OtherAUGUSTO ROBLES