Provider Demographics
NPI:1801308150
Name:TARIQ, SNOBER (DMD)
Entity type:Individual
Prefix:
First Name:SNOBER
Middle Name:
Last Name:TARIQ
Suffix:
Gender:F
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:BOSTON UNIVERSITY C/O DR. CALABRESE
Mailing Address - Street 2:100 E NEWTON ST RM G305C
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2308
Mailing Address - Country:US
Mailing Address - Phone:617-638-4741
Mailing Address - Fax:
Practice Address - Street 1:1725 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1862
Practice Address - Country:US
Practice Address - Phone:231-737-0037
Practice Address - Fax:231-760-5497
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL13483122300000X
MI2901600670122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist