Provider Demographics
NPI:1558799916
Name:SERAG, MAHMOUD (DDS)
Entity Type:Individual
Prefix:
First Name:MAHMOUD
Middle Name:
Last Name:SERAG
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 1:370 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1192
Mailing Address - Country:US
Mailing Address - Phone:919-980-9885
Mailing Address - Fax:
Practice Address - Street 1:370 JACKSON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1192
Practice Address - Country:US
Practice Address - Phone:919-980-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01301223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics