Provider Demographics
NPI:1538376173
Name:BELBEISI, WAFIQ (DDS)
Entity type:Individual
Prefix:DR
First Name:WAFIQ
Middle Name:
Last Name:BELBEISI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 INDUSTRIAL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176
Mailing Address - Country:US
Mailing Address - Phone:734-429-1323
Mailing Address - Fax:734-429-1332
Practice Address - Street 1:1235 INDUSTRIAL
Practice Address - Street 2:SUITE 2
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176
Practice Address - Country:US
Practice Address - Phone:734-429-1323
Practice Address - Fax:734-429-1332
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI15584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist