Provider Demographics
NPI:1790168912
Name:SAYED ALY MEKLED, SALWA
Entity Type:Individual
Prefix:
First Name:SALWA
Middle Name:
Last Name:SAYED ALY MEKLED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 BLACKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-4066
Mailing Address - Country:US
Mailing Address - Phone:502-619-4552
Mailing Address - Fax:
Practice Address - Street 1:6910 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4445
Practice Address - Country:US
Practice Address - Phone:915-317-7567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice