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Organization

WESTERN MASS PERIODONTICS PC

Active
Parent organization
WESTERN MASS PERIODONTICS PC
Other names
Akram E. Rafla DMD, PC, Northeast Periodontal Specialists
Organization subpart
Yes

Provider details

NPI number
Legal business name
WESTERN MASS PERIODONTICS PC
Authorized official
LEAH ANN MAYLOTT (CREDENTIALING ADMINISTRATOR)
(860) 874-8198
Entity
Organization

Contact information

Practice address
65 ELM ST, WORCESTER, MA 01609-2547
(508) 363-4400
Mailing address
65 ELM ST, WORCESTER, MA 01609-2547
(860) 874-8198

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary

Other

Enumeration date
08/29/2018
Last updated
08/19/2022
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