Basic Information
| Provider Information | |||||||||
| NPI: | 1477942548 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARWAR | ||||||||
| FirstName: | THAMAR | ||||||||
| MiddleName: | ANSARI | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2D DENTAL BATTALION HQ | ||||||||
| Address2: | |||||||||
| City: | CAMP LEJEUNE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104511658 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2D DENTAL BATTALION HQ | ||||||||
| Address2: | |||||||||
| City: | CAMP LEJEUNE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104511658 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2015 | ||||||||
| LastUpdateDate: | 08/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 0401414714 | VA | N | Dental Providers | Dentist | 122300000X | 7625 | NV | N | Dental Providers | Dentist | 122300000X | 38148 | TX | N | Dental Providers | Dentist | 122300000X | DEN.00205317 | CO | N | Dental Providers | Dentist | 122300000X | 12705 | NC | Y | Dental Providers | Dentist |
No ID Information.