Provider Demographics
NPI:1619106127
Name:MISSONNE, ALEMSEGED DEGEFU (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEMSEGED
Middle Name:DEGEFU
Last Name:MISSONNE
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 1:8426 WINKLER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5062
Mailing Address - Country:US
Mailing Address - Phone:832-767-4782
Mailing Address - Fax:
Practice Address - Street 1:8426 WINKLER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5062
Practice Address - Country:US
Practice Address - Phone:832-767-4782
Practice Address - Fax:877-425-4661
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice