Provider Demographics
NPI:1982871984
Name:MAHMOOD, IKRAM ABDULKERIM (DDS MS)
Entity Type:Individual
Prefix:MRS
First Name:IKRAM
Middle Name:ABDULKERIM
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:DDS MS
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Mailing Address - Street 1:11 W FOURTEEN MILE ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-3104
Mailing Address - Country:US
Mailing Address - Phone:248-288-3579
Mailing Address - Fax:248-288-3560
Practice Address - Street 1:11 W FOURTEEN MILE ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-3104
Practice Address - Country:US
Practice Address - Phone:248-288-3579
Practice Address - Fax:248-288-3560
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI29010131741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics