Provider Demographics
NPI:1386950962
Name:ALLIANCE DENTISTS
Entity type:Organization
Organization Name:ALLIANCE DENTISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMMINE
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:YAMMINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:1281-318-1291
Mailing Address - Street 1:1107 E JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-5821
Mailing Address - Country:US
Mailing Address - Phone:281-318-1291
Mailing Address - Fax:281-715-2188
Practice Address - Street 1:1107 E JAMES ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-5821
Practice Address - Country:US
Practice Address - Phone:281-318-1291
Practice Address - Fax:281-715-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty