Individual
MARYAM MOHAMMADVALI SAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
292 CHAUNCY ST # 150, MANSFIELD, MA 02048-1203
(508) 406-9592
Mailing address
5 LAKESHORE CTR UNIT 1251, BRIDGEWATER, MA 02324-1084
(617) 909-2300
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
1857760
MA
1223E0200X
Endodontics
Primary
DN1857760
MA
1223G0001X
General Practice Dentistry
DN1857760
MA
Other
Enumeration date
10/02/2017
Last updated
04/16/2023
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