Provider Demographics
NPI:1861834566
Name:MAHMOOD, AMIR ALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:ALI
Last Name:MAHMOOD
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 1:1818 ROGERS RD
Mailing Address - Street 2:APT 231
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4586
Mailing Address - Country:US
Mailing Address - Phone:210-414-8949
Mailing Address - Fax:
Practice Address - Street 1:1615 TRUEMPER RD
Practice Address - Street 2:DUNN DENTAL CLINIC JBSA-LACKLAND
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-414-8949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program