Provider Demographics
NPI:1407077498
Name:GUIRGUIS, MAGED (DDS)
Entity Type:Individual
Prefix:
First Name:MAGED
Middle Name:
Last Name:GUIRGUIS
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 1:33790 BAINBRIDGE RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2947
Mailing Address - Country:US
Mailing Address - Phone:440-248-5333
Mailing Address - Fax:
Practice Address - Street 1:33790 BAINBRIDGE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2947
Practice Address - Country:US
Practice Address - Phone:440-248-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH199911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice