Provider Demographics
NPI:1104086875
Name:ALASSAAD, SAMER SAID (DDS)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:SAID
Last Name:ALASSAAD
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 1:635 ANDERSON RD STE 17
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3505
Mailing Address - Country:US
Mailing Address - Phone:530-757-6453
Mailing Address - Fax:530-757-6450
Practice Address - Street 1:635 ANDERSON RD STE 17
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-757-6453
Practice Address - Fax:530-757-6450
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice