Provider Demographics
NPI:1649508276
Name:ALOMAR, MOAYAD SALEH (DMD)
Entity type:Individual
Prefix:DR
First Name:MOAYAD
Middle Name:SALEH
Last Name:ALOMAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E ALGONQUIN RD
Mailing Address - Street 2:STE 300
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4373
Mailing Address - Country:US
Mailing Address - Phone:847-640-1112
Mailing Address - Fax:847-510-0548
Practice Address - Street 1:605 E ALGONQUIN RD
Practice Address - Street 2:STE 300
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4373
Practice Address - Country:US
Practice Address - Phone:847-640-1112
Practice Address - Fax:847-510-0548
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027896122300000X
IL0210023151223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist