Individual
DR. AHMED ELDIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.D.S, DDS
Contact information
Practice address
6714 S WESTNEDGE AVE, PORTAGE, MI 49002-3538
(800) 277-3633
Mailing address
6714 S WESTNEDGE AVE, PORTAGE, MI 49002-3538
(800) 277-3633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021060
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901021060
MICHIGAN DENTAL BOARD
MI
Enumeration date
07/18/2013
Last updated
07/18/2013
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