Provider Demographics
NPI:1023710746
Name:EL-AWADI NORTHVILLE DDS PLLC
Entity type:Organization
Organization Name:EL-AWADI NORTHVILLE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WASSIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EL AWADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-377-0264
Mailing Address - Street 1:41620 SIX MILE RD 101
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168
Mailing Address - Country:US
Mailing Address - Phone:248-349-3660
Mailing Address - Fax:
Practice Address - Street 1:41620 6 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-8528
Practice Address - Country:US
Practice Address - Phone:248-349-3660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental