Provider Demographics
NPI:1225458011
Name:JABOUR, ANWAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:
Last Name:JABOUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANWAR
Other - Middle Name:
Other - Last Name:ALHAZMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:11457 MAYFIELD RD
Mailing Address - Street 2:APT# 1052
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-5912
Mailing Address - Country:US
Mailing Address - Phone:813-760-4012
Mailing Address - Fax:
Practice Address - Street 1:11457 MAYFIELD RD
Practice Address - Street 2:APT# 1052
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:813-760-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program