Individual
MAHMOUD MOHAMED ABOULFARAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11201 SHAKER BLVD STE 136, CLEVELAND, OH 44104-3833
(216) 368-7238
Mailing address
11201 SHAKER BLVD STE 136, CLEVELAND, OH 44104-3833
(216) 368-7238
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.026959
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4399740
—
OR
Enumeration date
08/12/2022
Last updated
08/12/2022
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