Provider Demographics
NPI:1548612500
Name:METWALLY, AHMED (DMD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:METWALLY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 FALLS OF NEUSE RD STE C
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6866
Mailing Address - Country:US
Mailing Address - Phone:704-438-6325
Mailing Address - Fax:
Practice Address - Street 1:6301 FALLS OF NEUSE RD STE C
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6866
Practice Address - Country:US
Practice Address - Phone:704-438-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice