Provider Demographics
NPI:1396182259
Name:ALSAMERAI, LAITH SAADI
Entity Type:Individual
Prefix:DR
First Name:LAITH
Middle Name:SAADI
Last Name:ALSAMERAI
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 JACKSON XING
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2039
Mailing Address - Country:US
Mailing Address - Phone:708-445-2668
Mailing Address - Fax:
Practice Address - Street 1:2444 PACKARD RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1822
Practice Address - Country:US
Practice Address - Phone:734-572-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010209361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice