Provider Demographics
NPI:1770092017
Name:LAYTH SARAF, DMD, PA
Entity type:Organization
Organization Name:LAYTH SARAF, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LAYTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-925-0933
Mailing Address - Street 1:100 VILLAGE CIRCLE WAY APT 832
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1817 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7901
Practice Address - Country:US
Practice Address - Phone:336-275-6144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10762261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental