Facial Beauty Dental, PLLC

Organization Active NPI General Practice Dentistry · Wixom, MI

NPI 1063804334 · NPPES record last updated Feb 24, 2015

Key facts

NPI
1063804334
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901013824 (MI)
Legal business name
FACIAL BEAUTY DENTAL, PLLC
Practice address
3255 W Maple Rd
Wixom, MI 48393-4585
Phone
(248) 669-4141
NPI assigned
Feb 24, 2015
Organization subpart
No

Authorized official

Name
Gordon Phillip Smith, D.D.S.
Title
Owner
Phone
(248) 669-4141

National Provider Directory

Locations

3255 W Maple Rd
Wixom, MI 48393
Phone (248) 669-4141

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 2901013824 MI Yes

Addresses

Primary practice location

3255 W Maple Rd
Wixom, MI 48393-4585

Mailing address

3255 W Maple Rd
Wixom, MI 48393-4585
Phone (248) 669-4141

Other providers in Wixom, MI

All providers in Wixom, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.