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General NPI Number Information
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NPI Number | 1144677501
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Entity Type | Individual
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Provider Name | PRINCESS ELHOSARY DMD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 7633 E JEFFERSON AVE SUITE 70
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City | DETROIT
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State | MI
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Zip | 48214-3730
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Country | US
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Telephone | 313-499-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 7715 GALL BLVD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-4315
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Country | US
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Telephone | 813-782-4200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22761
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License Number State | FL
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