Basic Information
| Provider Information | |||||||||
| NPI: | 1417280272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABOULHOSN | ||||||||
| FirstName: | NADIA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | |||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2722 COLBY AVE | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255511000 | ||||||||
| FaxNumber: | 4255511007 | ||||||||
| Practice Location | |||||||||
| Address1: | 2722 COLBY AVE | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255511000 | ||||||||
| FaxNumber: | 4255511007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2009 | ||||||||
| LastUpdateDate: | 09/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DE60102357 | WA | Y | Dental Providers | Dentist |
No ID Information.