MEDICARE: DR. MANAF SAKER D.M.D.

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	22DI01979200	NJ

General Provider Information

NPI Number	:	1861417040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANAF SAKER D.M.D.

Provider Business Mailing Address
First Line	:	385 S MAPLE AVE
Second Line	:	SUITE 207
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-1543
Country	:	US
Telephone Number	:	201-444-5355
Fax Number	:	201-444-5502

Provider Business Practice Location Address
First Line	:	385 S MAPLE AVE
Second Line	:	SUITE 207
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-1543
Country	:	US
Telephone Number	:	201-444-5355
Fax Number	:	201-444-5502

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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