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Organization
ZAKI M MUKDISSI DMD PC
Active
Organization
ZAKI M MUKDISSI DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZAKI M MUKDISSI DMD (PRESIDENT)
(781) 306-9644
Entity
Organization
Contact information
Practice address
616 FELLSWAY, SECOND FLOOR, MEDFORD, MA 02155
(781) 306-9644
(781) 306-9726
Mailing address
616 FELLSWAY, SECOND FLOOR, MEDFORD, MA 02155
(781) 306-9644
(781) 306-9726
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19475
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201456
MASS HEALTH
MA
Enumeration date
09/05/2006
Last updated
08/22/2020
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