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General NPI Number Information
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NPI Number | 1417748492
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Entity Type | Individual
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Provider Name | SAMAR ALI CHARARA
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Gender | Female
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 10413 FORD RD UNIT N
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City | DEARBORN
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State | MI
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Zip | 48126-3334
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Country | US
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Telephone | 313-769-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 26601 ASHLEY ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-1906
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Country | US
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Telephone | 313-229-1241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901602581
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License Number State | MI
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