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Individual

OMAR ALBASHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5521 BELLAIRE DR S STE 210, FORT WORTH, TX 76109-5900
(817) 623-4047
Mailing address
5521 BELLAIRE DR S STE 210, FORT WORTH, TX 76109-5900
(551) 214-4133

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02761700
NJ
122300000X
Dentist
41305
TX
1223P0221X
Pediatric Dentistry
Primary
41305
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119591300
MD
Enumeration date
07/16/2019
Last updated
08/03/2025
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