Provider Demographics
NPI:1750631628
Name:FUTURE IMAGE DENTAL PC
Entity type:Organization
Organization Name:FUTURE IMAGE DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAWAR
Authorized Official - Middle Name:ATHEER
Authorized Official - Last Name:KARMO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-310-6955
Mailing Address - Street 1:39595 W 10 MILE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2948
Mailing Address - Country:US
Mailing Address - Phone:248-477-7230
Mailing Address - Fax:
Practice Address - Street 1:39595 W 10 MILE RD STE 106
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2948
Practice Address - Country:US
Practice Address - Phone:248-477-7230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010199861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty