Provider Demographics
NPI:1619585270
Name:DENTIST NEAR ME PLLC
Entity type:Organization
Organization Name:DENTIST NEAR ME PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:IMAD
Authorized Official - Last Name:ALHARIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-319-0222
Mailing Address - Street 1:1603 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1541
Mailing Address - Country:US
Mailing Address - Phone:901-319-0222
Mailing Address - Fax:
Practice Address - Street 1:1603 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1541
Practice Address - Country:US
Practice Address - Phone:901-319-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty