Provider Demographics
NPI:1376625558
Name:SOBH, ALI AHMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:AHMAD
Last Name:SOBH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14639 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3173
Mailing Address - Country:US
Mailing Address - Phone:313-582-1960
Mailing Address - Fax:313-582-2414
Practice Address - Street 1:14639 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3173
Practice Address - Country:US
Practice Address - Phone:313-582-1960
Practice Address - Fax:313-582-2414
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist