Provider Demographics
NPI:1740919968
Name:ABDUL KHALEK, AL BARAA (DDS)
Entity type:Individual
Prefix:DR
First Name:AL BARAA
Middle Name:
Last Name:ABDUL KHALEK
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 1:26977 HAVELOCK DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3688
Mailing Address - Country:US
Mailing Address - Phone:734-747-0569
Mailing Address - Fax:
Practice Address - Street 1:33966 W 8 MILE RD STE 104
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5273
Practice Address - Country:US
Practice Address - Phone:248-474-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist