Organization
AMMAR F FARRA DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMMAR F FARRA DMD (OWNER/DENTIST)
(781) 245-1955
Entity
Organization
Contact information
Practice address
6 ALBION ST, WAKEFIELD, MA 01880-2802
(781) 245-1955
(781) 245-0186
Mailing address
6 ALBION ST, WAKEFIELD, MA 01880-2802
(781) 245-1955
(781) 245-0186
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
19055
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11872
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/05/2007
Last updated
10/05/2007
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