Individual
FATIMA NAUROSE SIRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
860 EAST HIGHWAY 114 IDEAL DENTAL, SUITE 200, ROANOKE, TX 76262
(817) 491-3000
(214) 291-9582
Mailing address
1230 NOCONA DRIVE,, IRVING, TX 75063
(847) 668-2783
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030215
IL
1223G0001X
General Practice Dentistry
019030215
IL
Other
Enumeration date
07/07/2015
Last updated
12/19/2018
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