Provider Demographics
NPI:1306928643
Name:SHAABAN, ALI A (DDS)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:A
Last Name:SHAABAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1658 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2879
Mailing Address - Country:US
Mailing Address - Phone:734-421-1181
Mailing Address - Fax:734-421-4538
Practice Address - Street 1:1658 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2879
Practice Address - Country:US
Practice Address - Phone:734-421-1181
Practice Address - Fax:734-421-4538
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018367122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist