Provider Demographics
NPI:1104233311
Name:HUSSAIN, NOMAN (DMD)
Entity type:Individual
Prefix:DR
First Name:NOMAN
Middle Name:
Last Name:HUSSAIN
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 1:400 E HIGHWAY 90 STE 402
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-2630
Mailing Address - Country:US
Mailing Address - Phone:936-681-8592
Mailing Address - Fax:
Practice Address - Street 1:400 E HIGHWAY 90 STE 402
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-2630
Practice Address - Country:US
Practice Address - Phone:936-681-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-20
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist