Provider Demographics
NPI:1013238435
Name:BABER, SAM (DDS)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:BABER
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 1:27487 W HIGHWAY 84
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-3717
Mailing Address - Country:US
Mailing Address - Phone:254-848-9566
Mailing Address - Fax:
Practice Address - Street 1:27487 W HIGHWAY 84
Practice Address - Street 2:
Practice Address - City:MC GREGOR
Practice Address - State:TX
Practice Address - Zip Code:76657-3717
Practice Address - Country:US
Practice Address - Phone:254-848-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist