Organization

G Ghannam D D S

Dental Clinic/Center in Detroit, MI(View on Map)

Legal Business Name

G Ghannam D D S

NPI Number

1255508800

NPI Type

Organization

Enumeration Date

05/13/2008

Specialties

(Taxonomies)

Code

261QD0000X
1223G0001X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

5705 W VERNOR HWY
5705 W VERNOR HWY

City

Detroit
Detroit

State

MI
MI

Postal Code

48209-2157
48209-2157

Country

US
US

Telephone Number

(313) 842-3770
(313) 842-3770

Authorized Official

Name

Ghanem Ghannam

Title or Position

SOLE OWNER

Telephone Number

(313) 842-3770

Identifiers

Identifier

1692476

Identifier State

MI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/29/2024

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