Individual
DR. MOATAZ MOHAMMED SHABAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS, DMD
Contact information
Practice address
439 MAIN ST STE A, INDIAN ORCHARD, MA 01151-1239
(413) 543-1202
Mailing address
439 MAIN ST STE A, INDIAN ORCHARD, MA 01151-1239
(413) 543-1202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22158
MA
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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