Provider Demographics
NPI:1285835918
Name:MIKAIEL, MAGDY G (DDS)
Entity Type:Individual
Prefix:MR
First Name:MAGDY
Middle Name:G
Last Name:MIKAIEL
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 1:1625 STRAITS TURNPIKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2846
Mailing Address - Country:US
Mailing Address - Phone:203-598-3889
Mailing Address - Fax:203-598-0108
Practice Address - Street 1:1625 STRAITS TURNPIKE
Practice Address - Street 2:SUITE 210
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2846
Practice Address - Country:US
Practice Address - Phone:203-598-3889
Practice Address - Fax:203-598-0108
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007898122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist