Basic Information
| Provider Information | |||||||||
| NPI: | 1003297375 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUSIF | ||||||||
| FirstName: | SALWAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39042 DEQUINDRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483101701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5869838333 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 39042 DEQUINDRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5869838333 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2015 | ||||||||
| LastUpdateDate: | 07/20/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 2901021579 | MI | Y | Dental Providers | Dentist |
No ID Information.