MEDICARE: YEHIA ELGOHARY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10655	CO
2	122300000X	Dentist	27706	TX

General Provider Information

NPI Number	:	1760755532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEHIA ELGOHARY DDS

Provider Business Mailing Address
First Line	:	2707 COLE AVE
Second Line	:	APT 324
City	:	DALLAS
State	:	TX
Zip	:	75204-1006
Country	:	US
Telephone Number	:	352-434-8014
Fax Number	:

Provider Business Practice Location Address
First Line	:	2707 COLE AVE
Second Line	:	APT 324
City	:	DALLAS
State	:	TX
Zip	:	75204-1006
Country	:	US
Telephone Number	:	352-434-8014
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2012
Last Update Date	:	10/28/2016

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Directions to “ YEHIA ELGOHARY DDS” Practice Location

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