Organization
LUX DENTAL CENTER
Active
Other names
LUX DENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ABDULLAIBRAHIM ABDULWAHEED (OWNER)
(617) 639-5942
Entity
Organization
Contact information
Practice address
181 WASHINGTON ST, SOMERVILLE, MA 02143-3137
(617) 639-5942
(888) 832-8267
Mailing address
181 WASHINGTON ST, SOMERVILLE, MA 02143-3137
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053710400
—
MA
05
—
1083029102
—
MA
05
—
1235752189
—
MA
05
—
1275916116
—
MA
05
—
1427424332
—
MA
05
—
1578939351
—
MA
05
—
1619347788
—
MA
05
—
1699143917
—
MA
05
—
1760576250
—
MA
05
—
1790121259
—
MA
05
—
1801220009
—
MA
05
—
1851932198
—
MA
05
—
1861878712
—
MA
05
—
1891251559
—
MA
05
—
1922668961
—
MA
Enumeration date
08/26/2020
Last updated
08/27/2020
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