Provider Demographics
NPI:1790955417
Name:BAGHDADI-GEGATI, MARCEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARCEL
Middle Name:
Last Name:BAGHDADI-GEGATI
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 1:10320 NW 17TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6620
Mailing Address - Country:US
Mailing Address - Phone:954-632-3310
Mailing Address - Fax:954-474-8106
Practice Address - Street 1:300 NW 70TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2384
Practice Address - Country:US
Practice Address - Phone:954-792-4100
Practice Address - Fax:954-474-8106
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist