Individual
KAMYAR RAISS GIGLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 ESSEX CENTER DR STE 112, PEABODY, MA 01960
(978) 531-1450
Mailing address
100 E NEWTON ST, G-305, BOSTON, MA 02118-2308
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1857854
MA
Other
Enumeration date
05/05/2014
Last updated
07/27/2018
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