Provider Demographics
NPI:1720952906
Name:NEW HAVEN DENTAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:NEW HAVEN DENTAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-910-4819
Mailing Address - Street 1:59041 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48048-2057
Mailing Address - Country:US
Mailing Address - Phone:586-749-3333
Mailing Address - Fax:586-749-3334
Practice Address - Street 1:59041 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:MI
Practice Address - Zip Code:48048-2057
Practice Address - Country:US
Practice Address - Phone:586-749-3333
Practice Address - Fax:586-749-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty