Provider Demographics
NPI:1760150163
Name:SABOOR, ABDUL (DDS)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:SABOOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 TRINITY RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5817
Mailing Address - Country:US
Mailing Address - Phone:786-214-9059
Mailing Address - Fax:
Practice Address - Street 1:22010 EUREKA RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5233
Practice Address - Country:US
Practice Address - Phone:786-214-9059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist