Provider Demographics
NPI:1053820977
Name:DELUXE DENTAL PLLC # 3
Entity type:Organization
Organization Name:DELUXE DENTAL PLLC # 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FADDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-991-6299
Mailing Address - Street 1:47059 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3357
Mailing Address - Country:US
Mailing Address - Phone:586-991-6299
Mailing Address - Fax:586-799-4076
Practice Address - Street 1:47059 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3357
Practice Address - Country:US
Practice Address - Phone:586-991-6299
Practice Address - Fax:586-799-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty