Provider Demographics
NPI:1083456842
Name:NADER, TAREK (DDS)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:NADER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 REVLAND DR
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:ON
Mailing Address - Zip Code:N8N 5B1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37380 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5447
Practice Address - Country:US
Practice Address - Phone:734-535-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016022171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice