Provider Demographics
NPI:1881880102
Name:A&S DENTAL
Entity type:Organization
Organization Name:A&S DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-565-4666
Mailing Address - Street 1:6022 W MAPLE RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4408
Mailing Address - Country:US
Mailing Address - Phone:248-565-4666
Mailing Address - Fax:248-565-4667
Practice Address - Street 1:6022 W MAPLE RD
Practice Address - Street 2:SUITE 415
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4408
Practice Address - Country:US
Practice Address - Phone:248-565-4666
Practice Address - Fax:248-565-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017875122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty