Individual
DR. MOHAMED R ILSHAHUOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
103 COMMONWEALTH AVE, ATTLEBORO FALLS, MA 02763-1015
(508) 699-0449
(508) 699-4344
Mailing address
103 COMMONWEALTH AVE, ATTLEBORO FALLS, MA 02763-1015
(646) 371-3561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
063595
NY
122300000X
Dentist
Primary
DL13593
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063595-01
NYS DENTAL LICENSE
NY
Enumeration date
06/26/2018
Last updated
09/27/2024
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