Provider Demographics
NPI:1932319050
Name:NASEEM-ELKASSAS, NAILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAILA
Middle Name:
Last Name:NASEEM-ELKASSAS
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 1:409 CENTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845-1307
Mailing Address - Country:US
Mailing Address - Phone:814-965-2433
Mailing Address - Fax:814-965-2421
Practice Address - Street 1:409 CENTER ST STE A
Practice Address - Street 2:
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845-1307
Practice Address - Country:US
Practice Address - Phone:814-965-2433
Practice Address - Fax:814-965-2421
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027789L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice