Provider Demographics
NPI:1952783284
Name:ALMOHARIB, HANI SAUD (BDS)
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:SAUD
Last Name:ALMOHARIB
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KNEELAND STREET,
Mailing Address - Street 2:12TH FLOOR PERIODONTOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-6531
Mailing Address - Fax:
Practice Address - Street 1:1 KNEELAND STREET,
Practice Address - Street 2:12TH FLOOR PERIODONTOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program