Provider Demographics
NPI:1629240452
Name:EL-MALECKI, MAGED A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAGED
Middle Name:A
Last Name:EL-MALECKI
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 1:19 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1225
Mailing Address - Country:US
Mailing Address - Phone:781-643-2344
Mailing Address - Fax:781-641-3483
Practice Address - Street 1:19 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-1225
Practice Address - Country:US
Practice Address - Phone:781-643-2344
Practice Address - Fax:781-641-3483
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice