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General NPI Number Information
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NPI Number | 1770092017
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Entity Type | Organization
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Legal Business Name | LAYTH SARAF, DMD, PA
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 1817 PEMBROKE RD
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City | GREENSBORO
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State | NC
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Zip | 27408-7901
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Country | US
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Telephone | 336-275-6144
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Fax |
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Provider Business Mailing Address
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Address Line | 100 VILLAGE CIRCLE WAY APT 832
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City | DURHAM
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State | NC
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Zip | 27713-6136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | LAYTH SARAF
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Credential | DMD
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Telephone | 410-925-0933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 10762
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License Number State | NC
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