Individual
DR. OMAR AHMAD ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-4251
Mailing address
200 LORI CT, MEDINAH, IL 60157-9733
(815) 519-0650
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
TBD
IL
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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