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General NPI Number Information
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NPI Number | 1639427123
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Entity Type | Organization
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Legal Business Name | DENTIST ON WHEELS, INC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 20 F ST NW 7TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20001-6700
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Country | US
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Telephone | 855-369-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 SW 148TH AVE #110
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City | MIRAMAR
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State | FL
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Zip | 33027-3257
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Country | US
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Telephone | 855-369-8585
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. AYMAN ALI
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Credential | DMD
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Telephone | 855-369-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11746
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License Number State | GA
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