Provider Demographics
NPI:1801099759
Name:ALHOMSI, MOHAMAD H (DDS)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:H
Last Name:ALHOMSI
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 1:120 DAVANT ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2353
Mailing Address - Country:US
Mailing Address - Phone:706-627-7577
Mailing Address - Fax:
Practice Address - Street 1:13899 HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2135
Practice Address - Country:US
Practice Address - Phone:952-440-2292
Practice Address - Fax:952-440-2935
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND123761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice