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General NPI Number Information
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NPI Number | 1043983372
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Entity Type | Individual
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Provider Name | MAAREF FADEL DDS
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 6760 ALLEN RD STE 101
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City | ALLEN PARK
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State | MI
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Zip | 48101-2062
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Country | US
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Telephone | 250-031-3928
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Fax |
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Provider Business Mailing Address
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Address Line | 25531 AVONDALE ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1001
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Country | US
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Telephone | 313-207-3702
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901600883
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License Number State | MI
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