Individual
ABDULWAHAB KHODADAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
635 ALBANY ST, BOSTON, MA 02118-3550
(617) 650-9014
Mailing address
45 STUART ST APT 1217, BOSTON, MA 02116-4751
(617) 650-9014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DL15876
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
09/25/2023
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