Provider Demographics
NPI:1699203216
Name:HOURI, SAMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:
Last Name:HOURI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SAMER
Other - Middle Name:
Other - Last Name:ALHOURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3365 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3365 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2874
Practice Address - Country:US
Practice Address - Phone:313-749-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
MI29016011281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program