MEDICARE: MICHAEL I. ALHARIR DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346764214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL I. ALHARIR DDS PC

Provider Business Mailing Address
First Line	:	1507 W PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 W PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3029
Country	:	US
Telephone Number	:	215-372-0060
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL IMAD ALHARIR
Credential	:	DDS
Telephone Number	:	901-319-0222

Provider Enumeration Date	:	08/01/2017
Last Update Date	:	08/01/2017

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