Provider Demographics
NPI:1912696303
Name:DRS MAHER MAHDI & SAMI DENTAL CORP
Entity Type:Organization
Organization Name:DRS MAHER MAHDI & SAMI DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-615-4998
Mailing Address - Street 1:702 PORTER AVE STE F
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4297
Mailing Address - Country:US
Mailing Address - Phone:505-615-4998
Mailing Address - Fax:
Practice Address - Street 1:702 PORTER AVE STE F
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4297
Practice Address - Country:US
Practice Address - Phone:505-615-4998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty