Provider Demographics
NPI:1073236881
Name:EHAB SAMAAN DDS, INC
Entity Type:Organization
Organization Name:EHAB SAMAAN DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:MR
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:SEDKY
Authorized Official - Last Name:SAMAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-420-1701
Mailing Address - Street 1:4200 N LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1558
Mailing Address - Country:US
Mailing Address - Phone:562-420-1701
Mailing Address - Fax:562-421-8447
Practice Address - Street 1:4200 N LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1558
Practice Address - Country:US
Practice Address - Phone:562-420-1701
Practice Address - Fax:562-421-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty