Provider Demographics
NPI:1215255898
Name:GABR, SHERIF (DDS)
Entity type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:GABR
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 1:225 N MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4926
Mailing Address - Country:US
Mailing Address - Phone:860-582-4485
Mailing Address - Fax:
Practice Address - Street 1:225 N MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4926
Practice Address - Country:US
Practice Address - Phone:860-582-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist