Provider Demographics
NPI:1821138140
Name:SYED, SATTAR A (DMD PA)
Entity Type:Individual
Prefix:DR
First Name:SATTAR
Middle Name:A
Last Name:SYED
Suffix:
Gender:M
Credentials:DMD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MAGNOLIA WAY
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9692
Mailing Address - Country:US
Mailing Address - Phone:215-205-9033
Mailing Address - Fax:
Practice Address - Street 1:5507 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5001
Practice Address - Country:US
Practice Address - Phone:302-994-3093
Practice Address - Fax:302-994-5699
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE208145184Medicaid