Provider Demographics
NPI:1164918074
Name:ALI, ANUM FEROZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANUM
Middle Name:FEROZ
Last Name:ALI
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 1:3420 DALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6652
Mailing Address - Country:US
Mailing Address - Phone:167-876-3891
Mailing Address - Fax:
Practice Address - Street 1:260 HAMILTON CROSSING DR
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2262
Practice Address - Country:US
Practice Address - Phone:865-978-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice