Individual
BASEL OTOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 INDIAN HILL ROAD, WEST TISBURY, MA 02575
(508) 338-7170
Mailing address
77 HOSPITAL AVE, NORTH ADAMS, MA 01247-2550
(617) 697-0545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL15170
MA
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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