Individual
DR. SADRU P KABANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MS
Contact information
Practice address
100 E NEWTON ST G-04, BONSTON UNIV OF DENTAL MED, DEPT OF ORAL & MAXILLO PATH, BOSTON, MA 02118-2308
(617) 638-5005
(617) 638-4697
Mailing address
100 E NEWTON ST G-04, BONSTON UNIV OF DENTAL MED, DEPT OF ORAL & MAXILLO PATH, BOSTON, MA 02118-2308
(617) 638-5005
(617) 638-4697
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
14278
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0806005
—
MA
01
—
25443
FALLON COMM HEALTH
—
01
—
3068028
AETNA
—
01
—
711511
TUFTS HEALTH PLAN
—
01
—
8000239
UNITED HEALTH
—
01
—
AA1699
HARVARD PILGRIM
—
Enumeration date
08/30/2006
Last updated
07/08/2007
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