Provider Demographics
NPI:1184821720
Name:MALEK ESRAWI DMD. PC
Entity Type:Organization
Organization Name:MALEK ESRAWI DMD. PC
Other - Org Name:ADVANCED COSMETIC & IIMPLANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALEK
Authorized Official - Middle Name:
Authorized Official - Last Name:ESRAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PC
Authorized Official - Phone:508-771-4044
Mailing Address - Street 1:197 BARNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-2929
Mailing Address - Country:US
Mailing Address - Phone:508-771-4044
Mailing Address - Fax:508-771-0922
Practice Address - Street 1:197 BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2929
Practice Address - Country:US
Practice Address - Phone:508-771-4044
Practice Address - Fax:508-771-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA193611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty