Provider Demographics
NPI:1306076237
Name:TABEL, SAMER NASR (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMER
Middle Name:NASR
Last Name:TABEL
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 1:27310 STONEHENGE CIR
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-8189
Mailing Address - Country:US
Mailing Address - Phone:951-719-7916
Mailing Address - Fax:951-658-2837
Practice Address - Street 1:27310 STONEHENGE CIR
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-8189
Practice Address - Country:US
Practice Address - Phone:951-719-7916
Practice Address - Fax:951-658-2837
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist