Individual
ESRAA ABDULGADER TASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E NEWTON ST, SUITE 217, BOSTON, MA 02118-2308
(617) 638-4762
Mailing address
30 PARKSIDE PL, UNIT 407, MALDEN, MA 02148-7869
(857) 210-2900
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DL12152
MA
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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