Provider Demographics
NPI:1497495139
Name:DALI, SAFAA (DDS)
Entity Type:Individual
Prefix:
First Name:SAFAA
Middle Name:
Last Name:DALI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 IRELAN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1123
Mailing Address - Country:US
Mailing Address - Phone:919-987-5015
Mailing Address - Fax:
Practice Address - Street 1:15 RAWLS RD
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-6276
Practice Address - Country:US
Practice Address - Phone:919-639-2272
Practice Address - Fax:919-639-8654
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice