Provider Demographics
NPI:1902891807
Name:QADER, NASREEN SULTANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASREEN
Middle Name:SULTANA
Last Name:QADER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4838 SUNMORE PKWY
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-6718
Mailing Address - Country:US
Mailing Address - Phone:760-830-7054
Mailing Address - Fax:
Practice Address - Street 1:1591 GRIFFIN ST.
Practice Address - Street 2:
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8300
Practice Address - Country:US
Practice Address - Phone:760-830-7053
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS453111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics