Provider Demographics
NPI:1700812195
Name:MAGID, ADEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADEL
Middle Name:A
Last Name:MAGID
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 S LAPEER RD
Mailing Address - Street 2:#204
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-5084
Mailing Address - Country:US
Mailing Address - Phone:248-628-9707
Mailing Address - Fax:248-628-9775
Practice Address - Street 1:837 S LAPEER RD
Practice Address - Street 2:#204
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-5084
Practice Address - Country:US
Practice Address - Phone:248-628-9707
Practice Address - Fax:248-628-9775
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist