Individual
DR. ALI DAWLATLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 834-1798
Mailing address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
S9868
TX
208600000X
Surgery Physician
S9868
TX
Other
Enumeration date
05/09/2013
Last updated
02/24/2023
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