Provider Demographics
NPI:1174659445
Name:HUSAIN, ALI S (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:S
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PEOPLES PLZ
Mailing Address - Street 2:SUITE 312
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5707
Mailing Address - Country:US
Mailing Address - Phone:302-838-1400
Mailing Address - Fax:302-838-2232
Practice Address - Street 1:1400 PEOPLES PLZ
Practice Address - Street 2:SUITE 312
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5707
Practice Address - Country:US
Practice Address - Phone:302-838-1400
Practice Address - Fax:302-838-2232
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00010821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics