Provider Demographics
NPI:1164623112
Name:MESH, ALINE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALINE
Middle Name:A
Last Name:MESH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15555 SILVER PKWY
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-3445
Mailing Address - Country:US
Mailing Address - Phone:810-750-1000
Mailing Address - Fax:810-750-1444
Practice Address - Street 1:15555 SILVER PKWY
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-3445
Practice Address - Country:US
Practice Address - Phone:810-750-1000
Practice Address - Fax:810-750-1444
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice