Provider Demographics
NPI:1316391303
Name:SAED, MICHAEL I
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:I
Last Name:SAED
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 1:1074 W 6TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-1639
Mailing Address - Country:US
Mailing Address - Phone:951-279-7650
Mailing Address - Fax:
Practice Address - Street 1:1074 W 6TH ST STE 104
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1639
Practice Address - Country:US
Practice Address - Phone:951-279-7650
Practice Address - Fax:951-279-4723
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-16
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1008381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice