MEDICARE: MOHAMED H SABER B.D.S

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	1223E0200X	Endodontics	DE60305669	WA

General Provider Information

NPI Number	:	1821345935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED H SABER B.D.S

Provider Business Mailing Address
First Line	:	3106 SUMNER TAPPS HWY E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6716
Country	:	US
Telephone Number	:	253-891-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3106 SUMNER TAPPS HWY E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6716
Country	:	US
Telephone Number	:	253-891-3100
Fax Number	:

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

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	06/07/2016

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