MEDICARE: DR. MEHDI SABER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	16569	NJ

General Provider Information

NPI Number	:	1558459537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHDI SABER DDS

Provider Business Mailing Address
First Line	:	191 NORTH AVE E
Second Line	:
City	:	CRANFORD
State	:	NJ
Zip	:	07016-2438
Country	:	US
Telephone Number	:	908-709-6777
Fax Number	:	908-709-1142

Provider Business Practice Location Address
First Line	:	191 NORTH AVE E
Second Line	:
City	:	CRANFORD
State	:	NJ
Zip	:	07016-2438
Country	:	US
Telephone Number	:	908-709-6777
Fax Number	:	908-709-1142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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