MEDICARE: DR. YASSER SAAD ALALI DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	S-753	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S-753	OTHER	LA	RESTRICTED LICENSE FROM LOUISIANA STATE BOARD OF DENTISTRY

General Provider Information

NPI Number	:	1184059818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YASSER SAAD ALALI DDS

Provider Business Mailing Address
First Line	:	5243 BUTTER CREEK LN
Second Line	:	UNIT H7
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-0603
Country	:	US
Telephone Number	:	504-812-7709
Fax Number	:

Provider Business Practice Location Address
First Line	:	5243 BUTTER CREEK
Second Line	:	UNIT H7
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-0603
Country	:	US
Telephone Number	:	504-812-7709
Fax Number	:

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

Provider Enumeration Date	:	09/12/2013
Last Update Date	:	09/12/2013

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