Basic Information
| Provider Information | |||||||||
| NPI: | 1508519281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALSHAIR | ||||||||
| FirstName: | ALAA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | BDS, CAGS, MSCD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1102 4TH AVE | ||||||||
| Address2: | |||||||||
| City: | MOLINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 612651231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6183037850 | ||||||||
| FaxNumber: | 3095176217 | ||||||||
| Practice Location | |||||||||
| Address1: | FAMILIA DENTAL | ||||||||
| Address2: | 1102 4TH AVE | ||||||||
| City: | MOLINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 61265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095176217 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2022 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 019-033480 | IL | Y | Dental Providers | Dentist |
No ID Information.