Provider Demographics
NPI:1023168424
Name:ALEID, SAMER (DMD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:
Last Name:ALEID
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01536-2104
Mailing Address - Country:US
Mailing Address - Phone:508-839-9952
Mailing Address - Fax:
Practice Address - Street 1:318 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1124
Practice Address - Country:US
Practice Address - Phone:508-653-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA19622OtherMASS DENTAL LICENSE