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Individual

DR. TARIQ ELMADAWY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1551 PARK PL STE 300, GREEN BAY, WI 54304-1969
(920) 332-6644
Mailing address
2480 MARINA CIR UNIT 502, ASHWAUBENON, WI 54304-4877
(734) 502-8196

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601681
MI
122300000X
Dentist
6001237-15
WI

Other

Enumeration date
06/29/2023
Last updated
01/27/2025
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