Provider Demographics
NPI:1770645020
Name:MEROUEH, ALIA (DDS)
Entity Type:Individual
Prefix:
First Name:ALIA
Middle Name:
Last Name:MEROUEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13300 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3327
Mailing Address - Country:US
Mailing Address - Phone:313-584-0505
Mailing Address - Fax:313-584-5952
Practice Address - Street 1:13300 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3327
Practice Address - Country:US
Practice Address - Phone:313-584-0505
Practice Address - Fax:313-584-5952
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI144401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice