# DR. AHMED ELGAZAR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1265580658
- **Gender:** Man
- **Credential:** DDS.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 45853 | CA | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 03/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 139724 | UNITED COCORDIA | CA |
| 01 | — | B45853-01 | MEDICAL | CA |