Provider Demographics
NPI:1720461700
Name:ASHRAF, MOHAMMAD OMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:OMAR
Last Name:ASHRAF
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 1:2101 MAPLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-3954
Mailing Address - Country:US
Mailing Address - Phone:214-864-8893
Mailing Address - Fax:
Practice Address - Street 1:305 E CAMP WISDOM RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-2705
Practice Address - Country:US
Practice Address - Phone:972-296-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist