Individual
OMAR E ELBANHAWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
561 WOODS LN, GROSSE POINTE, MI 48236-1160
(410) 982-8440
Mailing address
561 WOODS LN, GROSSE POINTE, MI 48236-1160
(410) 982-8440
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
0401412910
VA
1223P0300X
Periodontics
Primary
2901021020
MI
Other
Enumeration date
10/14/2010
Last updated
06/10/2014
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