Provider Demographics
NPI:1720572282
Name:ALWATTAR, RAGHAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAGHAD
Middle Name:
Last Name:ALWATTAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6243 POST RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1223
Mailing Address - Country:US
Mailing Address - Phone:614-632-1073
Mailing Address - Fax:
Practice Address - Street 1:33533 W 12 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-5600
Practice Address - Country:US
Practice Address - Phone:855-408-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0237111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice