Provider Demographics
NPI:1922458793
Name:AL-ALFE, DALIA MAHMOUD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:MAHMOUD
Last Name:AL-ALFE
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 1:904 NEFF RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-2103
Mailing Address - Country:US
Mailing Address - Phone:317-657-0117
Mailing Address - Fax:
Practice Address - Street 1:22541 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2360
Practice Address - Country:US
Practice Address - Phone:586-777-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010218541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice