Individual
HAFSA WAHID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 HOLLAND ST STE 400, SOMERVILLE, MA 02144-2749
(617) 326-8627
Mailing address
1282 BOYLSTON ST UNIT 1225, BOSTON, MA 02215-4464
(214) 801-9628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000475
MA
Other
Enumeration date
03/31/2023
Last updated
09/17/2024
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