Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 2901020729 | MI |
NPI | 1184987075 |
---|---|
Provider Name | Dr. Yasser Alali |
First Address | Dearborn, MI 48128 |
Second Address | Dearborn, MI 48128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2012 |
Last Update Date | 18/02/2016 |