Provider Demographics
NPI:1942635370
Name:QADRI, MALIHA S (DMD)
Entity Type:Individual
Prefix:
First Name:MALIHA
Middle Name:S
Last Name:QADRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 NORTHCHASE PKWY SE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6405
Mailing Address - Country:US
Mailing Address - Phone:770-916-5362
Mailing Address - Fax:678-247-7829
Practice Address - Street 1:933 PLEASANT ST
Practice Address - Street 2:SUITE 102-103
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1000
Practice Address - Country:US
Practice Address - Phone:508-678-3044
Practice Address - Fax:508-673-4396
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18563651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice