Provider Demographics
NPI:1568815231
Name:DWELEE, MOHAMMED (DMD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:DWELEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E LEAGUE CITY PKWY APT 1115
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6049
Mailing Address - Country:US
Mailing Address - Phone:502-224-8072
Mailing Address - Fax:
Practice Address - Street 1:2555 E LEAGUE CITY PKWY
Practice Address - Street 2:160
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:713-346-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31691122300000X
KY9710122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist