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General NPI Number Information
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NPI Number | 1770737488
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Entity Type | Individual
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Provider Name | ABDELNASER MUSTAFA ELMAHDI B.D.S D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1944 BRASELTON HWY STE 107
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City | BUFORD
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State | GA
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Zip | 30519-3033
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Country | US
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Telephone | 770-696-9450
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Fax |
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Provider Business Mailing Address
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Address Line | 1944 BRASELTON HWY STE 107
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City | BUFORD
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State | GA
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Zip | 30519-3033
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Country | US
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Telephone | 770-696-9450
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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 | 2901020810
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27542
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2109642
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | RESIDENT AT MCG
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN014893
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License Number State | GA
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