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General NPI Number Information
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NPI Number | 1063335792
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Entity Type | Individual
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Provider Name | MOHAMAD ELGHOUL
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Gender | Male
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 4841 MONROE ST STE 260
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City | TOLEDO
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State | OH
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Zip | 43623-5324
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Country | US
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Telephone | 419-475-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 7640 MAPLE ST
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City | DEARBORN
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State | MI
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Zip | 48126-1135
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901603196
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.028611
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License Number State | OH
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