MEDICARE: DR. DINA M MURAD-NAMOU D.D.S

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	122300000X	Dentist	2901600692	MI

General Provider Information

NPI Number	:	1942816384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DINA M MURAD-NAMOU D.D.S

Provider Business Mailing Address
First Line	:	3726 DURHAM CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-1223
Country	:	US
Telephone Number	:	248-797-4004
Fax Number	:

Provider Business Practice Location Address
First Line	:	4469 METROPOLITAN PKWY
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4526
Country	:	US
Telephone Number	:	586-795-0980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2020
Last Update Date	:	09/21/2020

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