Provider Demographics
NPI:1043983372
Name:FADEL, MAAREF (DDS)
Entity type:Individual
Prefix:DR
First Name:MAAREF
Middle Name:
Last Name:FADEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25531 AVONDALE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-1001
Mailing Address - Country:US
Mailing Address - Phone:313-207-3702
Mailing Address - Fax:
Practice Address - Street 1:6760 ALLEN RD STE 101
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2062
Practice Address - Country:US
Practice Address - Phone:250-031-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist