Provider Demographics
NPI:1588966154
Name:IBN-AHMED, HUSSEN H (BDS)
Entity type:Individual
Prefix:
First Name:HUSSEN
Middle Name:H
Last Name:IBN-AHMED
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DRIVE UT HEALTH SCIENCE CENTER AT SAN A
Mailing Address - Street 2:MSC 7914, DEPT OF COMPREHENSIVE DENTISTRY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-567-3456
Mailing Address - Fax:210-567-3443
Practice Address - Street 1:7703 FLOYD CURL DRIVE UT HEALTH SCIENCE CENTER AT SAN A
Practice Address - Street 2:MSC 7903, ADVANCED GENERAL DENTISTRY CLINIC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3900
Practice Address - Country:US
Practice Address - Phone:210-567-3456
Practice Address - Fax:210-567-3443
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXUTSA925-X1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice