Provider Demographics
NPI:1619041241
Name:HOSSAIN NASRY DDS PC
Entity Type:Organization
Organization Name:HOSSAIN NASRY DDS PC
Other - Org Name:H & M DENTAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HOSSAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-575-8144
Mailing Address - Street 1:3821 W COSTCO DR
Mailing Address - Street 2:#103
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741
Mailing Address - Country:US
Mailing Address - Phone:520-575-8144
Mailing Address - Fax:520-575-8191
Practice Address - Street 1:3821 W COSTCO DR
Practice Address - Street 2:#103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-575-8144
Practice Address - Fax:520-575-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42821223G0001X
MO0151911223G0001X
CA518571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty