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General NPI Number Information
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NPI Number | 1265205538
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Entity Type | Individual
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Provider Name | DALIA MAGZOUB MOHAMED DMD
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Gender | Female
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 420 VILLAGE WALK DR
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-7699
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Country | US
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Telephone | 984-225-1710
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Fax |
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Provider Business Mailing Address
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Address Line | 108 PARK MANOR LN APT 402
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City | CARY
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State | NC
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Zip | 27519-7210
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Country | US
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Telephone | 812-764-0251
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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 | 13519
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License Number State | NC
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