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General NPI Number Information
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NPI Number | 1326969197
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Entity Type | Individual
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Provider Name | MOHAMED ELAGHORY
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Gender | Male
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 63 MAIN ST
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City | BROCKTON
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State | MA
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Zip | 02301-4042
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Country | US
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Telephone | 508-559-6699
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Fax |
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Provider Business Mailing Address
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Address Line | 11 TETLOW ST APT 28
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City | BOSTON
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State | MA
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Zip | 02115-5850
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Country | US
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Telephone | 585-386-9223
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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 | DL101749
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License Number State | MA
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