Provider Demographics
NPI:1124136825
Name:SHAROLLI, ABDOLMAJID (DDS)
Entity type:Individual
Prefix:
First Name:ABDOLMAJID
Middle Name:
Last Name:SHAROLLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:MAJID
Other - Middle Name:
Other - Last Name:SHAROLLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2100 BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-5626
Mailing Address - Country:US
Mailing Address - Phone:940-322-5297
Mailing Address - Fax:940-322-5298
Practice Address - Street 1:2100 BROOK AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5626
Practice Address - Country:US
Practice Address - Phone:940-322-5297
Practice Address - Fax:940-322-5298
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice