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General NPI Number Information
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NPI Number | 1043596752
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Entity Type | Organization
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Legal Business Name | ALI SHOAEE D.D.S.,P.C.
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 1013 DAIRY ASHFORD ST
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City | HOUSTON
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State | TX
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Zip | 77079-4602
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Country | US
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Telephone | 832-230-5222
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Fax | 832-230-5220
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Provider Business Mailing Address
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Address Line | 1013 DAIRY ASHFORD ST
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City | HOUSTON
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State | TX
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Zip | 77079-4602
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Country | US
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Telephone | 832-230-5222
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Fax | 832-230-5220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALI SHOAEE
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Credential | D.D.S.
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Telephone | 713-501-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 22119
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License Number State | TX
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