Provider Demographics
NPI:1417349861
Name:SAMER SHOUKFEH, D.D.S. PC
Entity Type:Organization
Organization Name:SAMER SHOUKFEH, D.D.S. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOUKFEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-459-4960
Mailing Address - Street 1:5958 N CANTON CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2765
Mailing Address - Country:US
Mailing Address - Phone:734-459-4960
Mailing Address - Fax:734-459-5069
Practice Address - Street 1:5958 N CANTON CENTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2765
Practice Address - Country:US
Practice Address - Phone:734-459-4960
Practice Address - Fax:734-459-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty