Individual
OSAMA AHMED QUTUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 E NEWTON ST, BOSTON, MA 02118-2308
(617) 638-5429
Mailing address
95 W SQUANTUM ST APT 1215, APT #1215, QUINCY, MA 02171-2136
(202) 459-8381
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DL10779
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223P0700X
DENTIST
MA
Enumeration date
09/30/2009
Last updated
09/30/2009
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