Provider Demographics
NPI:1407831837
Name:MAGREY, SANAM ALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANAM
Middle Name:ALI
Last Name:MAGREY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 CONCORD CIR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-2578
Mailing Address - Country:US
Mailing Address - Phone:440-385-0274
Mailing Address - Fax:
Practice Address - Street 1:3380 CONCORD CIR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-2578
Practice Address - Country:US
Practice Address - Phone:440-385-0274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0222291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice