Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | S3-328C | NV |
NPI | 1013469584 |
---|---|
Provider Name | Dr. Amin Abdallah |
First Address | Henderson, NV 89014-7826 |
Second Address | Henderson, NV 89014-7826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2016 |
Last Update Date | 10/08/2021 |