Provider Demographics
NPI:1922731215
Name:ABU-SNEINEH, HUSAM ABDEL-MAJID (DMD)
Entity Type:Individual
Prefix:DR
First Name:HUSAM
Middle Name:ABDEL-MAJID
Last Name:ABU-SNEINEH
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 1:27621 GERHART LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-8168
Mailing Address - Country:US
Mailing Address - Phone:209-640-4984
Mailing Address - Fax:
Practice Address - Street 1:2600 S TRACY BLVD STE 170
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-9111
Practice Address - Country:US
Practice Address - Phone:209-836-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS107417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist