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NPI Code Detail

MEDICARE: AMMAR AL SAADI DMD

MEDICARE: AMMAR AL SAADI DMD
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
1122300000XDentist1002650-15WI

General Provider Information

NPI Number : 1730752932
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMMAR AL SAADI DMD
Provider Business Mailing Address
First Line : 5351 N CALIFORNIA AVE APT 1S
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3413
Country : US
Telephone Number : 773-961-9448
Fax Number :
Provider Business Practice Location Address
First Line : 5341 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1365
Country : US
Telephone Number : 414-871-0827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2021
Last Update Date : 07/23/2021

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