MEDICARE: ZAHRAA SOLAGH

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	124Q00000X	Dental Hygienist	2902016338	MI

General Provider Information

NPI Number	:	1083254957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHRAA SOLAGH

Provider Business Mailing Address
First Line	:	6268 WHITEFIELD ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6268 WHITEFIELD ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3013
Country	:	US
Telephone Number	:	313-682-5888
Fax Number	:

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

Provider Enumeration Date	:	01/08/2020
Last Update Date	:	01/13/2020

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