Provider Demographics
NPI:1851648919
Name:ASMAR, FERIAL
Entity Type:Individual
Prefix:
First Name:FERIAL
Middle Name:
Last Name:ASMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W 14 MILE RD
Mailing Address - Street 2:202
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-3104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 W 14 MILE RD
Practice Address - Street 2:202
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-3104
Practice Address - Country:US
Practice Address - Phone:248-435-5789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI014955122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist