Provider Demographics
NPI:1134295199
Name:SAWERES, BASSEM ROSHDY
Entity Type:Individual
Prefix:DR
First Name:BASSEM
Middle Name:ROSHDY
Last Name:SAWERES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 TUPELO DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2740
Mailing Address - Country:US
Mailing Address - Phone:925-933-9192
Mailing Address - Fax:925-776-1148
Practice Address - Street 1:2590 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2909
Practice Address - Country:US
Practice Address - Phone:925-776-1142
Practice Address - Fax:925-776-1148
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice