Provider Demographics
NPI:1659413326
Name:SAOUD, MICHAEL S (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:SAOUD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2503
Mailing Address - Street 2:201 CENTENNIAL STREET, STE 1A
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-2503
Mailing Address - Country:US
Mailing Address - Phone:301-934-3500
Mailing Address - Fax:301-934-2277
Practice Address - Street 1:201 CENTENNIAL STREET, STE 1A
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-2503
Practice Address - Country:US
Practice Address - Phone:301-934-3500
Practice Address - Fax:301-934-2277
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD117401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice