Provider Demographics
NPI:1811007917
Name:DALLO, NADA (DDS)
Entity Type:Individual
Prefix:MISS
First Name:NADA
Middle Name:
Last Name:DALLO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:NAIDA
Other - Middle Name:
Other - Last Name:DALLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7598 N MESA
Mailing Address - Street 2:STE B4
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:915-584-8894
Mailing Address - Fax:915-584-8894
Practice Address - Street 1:7598 N MESA
Practice Address - Street 2:STE B4
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-584-8894
Practice Address - Fax:915-584-8894
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B153051OtherCHIP DELTA DENTAL
808227OtherUNITED CONCORDIA