Provider Demographics
NPI:1235836891
Name:AL AQORI, RASHIED NAGEEB AHMED KASSEM
Entity Type:Individual
Prefix:
First Name:RASHIED
Middle Name:NAGEEB AHMED KASSEM
Last Name:AL AQORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4146 W CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6894
Mailing Address - Country:US
Mailing Address - Phone:559-547-6749
Mailing Address - Fax:
Practice Address - Street 1:4146 W CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6894
Practice Address - Country:US
Practice Address - Phone:559-547-6749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1085941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice