Individual
DR. MAZEN KHALED ALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, DDS
Contact information
Practice address
4860 WASHTENAW AVE STE D, ANN ARBOR, MI 48108-3401
(734) 263-7545
Mailing address
4860 WASHTENAW AVE STE D, ANN ARBOR, MI 48108-3401
(734) 263-7545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601632
MI
390200000X
Student in an Organized Health Care Education/Training Program
ETN960
TX
Other
Enumeration date
07/07/2022
Last updated
07/21/2023
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