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Individual
WAEL ATT
Active
Individual
WAEL ATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DN1859376
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF11371
STATE LICENSE NUMBER- FACULTY DENTIST
MA
Enumeration date
08/16/2018
Last updated
06/03/2022
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