Provider Demographics
NPI:1679971857
Name:ALLAYMOUNI, MHD AMER
Entity Type:Individual
Prefix:
First Name:MHD AMER
Middle Name:
Last Name:ALLAYMOUNI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 SHERIDAN DR APT 2
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-9449
Mailing Address - Country:US
Mailing Address - Phone:716-650-8439
Mailing Address - Fax:
Practice Address - Street 1:723 SOUTHPARK BLVD STE F
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3628
Practice Address - Country:US
Practice Address - Phone:804-504-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014147051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics