Provider Demographics
NPI:1215170980
Name:NAGUIB, MICHELLE ADEL
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ADEL
Last Name:NAGUIB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 CARAMBOLA CIR S
Mailing Address - Street 2:#A104
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2300
Mailing Address - Country:US
Mailing Address - Phone:954-968-6518
Mailing Address - Fax:
Practice Address - Street 1:7797 N UNIVERSITY DR
Practice Address - Street 2:#201
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6110
Practice Address - Country:US
Practice Address - Phone:954-722-9339
Practice Address - Fax:954-722-7399
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 183301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice