MEDICARE: ALALI PC

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	122300000X	Dentist	2901020729	MI

General Provider Information

NPI Number	:	1023551777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALALI PC

Provider Business Mailing Address
First Line	:	3912 18 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-3826
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3912 18 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-3826
Country	:	US
Telephone Number	:	586-264-3200
Fax Number	:

Authorized Official
Title or Position	:	DDS OWNER
Name	:	DR. YASSER ALALI
Credential	:
Telephone Number	:	586-264-3200

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

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