Provider Demographics
NPI:1801274451
Name:SAMER K. RIAD D.D.S., P.L.L.C.
Entity type:Organization
Organization Name:SAMER K. RIAD D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:K
Authorized Official - Last Name:RIAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-693-1299
Mailing Address - Street 1:491 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-5350
Mailing Address - Country:US
Mailing Address - Phone:716-693-1299
Mailing Address - Fax:716-694-3418
Practice Address - Street 1:491 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-5350
Practice Address - Country:US
Practice Address - Phone:716-693-1299
Practice Address - Fax:716-694-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty