Provider Demographics
NPI:1598775991
Name:GEORGE E. SALIBA AND BASIL M. MOUKARIM DDS
Entity Type:Organization
Organization Name:GEORGE E. SALIBA AND BASIL M. MOUKARIM DDS
Other - Org Name:DENTAL ILLUSIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ELIE
Authorized Official - Last Name:SALIBA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-444-1755
Mailing Address - Street 1:13303 CHAMPION FOREST DR
Mailing Address - Street 2:BUILDING #5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2657
Mailing Address - Country:US
Mailing Address - Phone:281-444-1755
Mailing Address - Fax:281-444-1314
Practice Address - Street 1:13303 CHAMPION FOREST DR
Practice Address - Street 2:BUILDING #5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2657
Practice Address - Country:US
Practice Address - Phone:281-444-1755
Practice Address - Fax:281-444-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty