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Organization

MASS AVE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AHMED EL SAMRA (DENTIST)
(978) 582-0800
Entity
Organization

Contact information

Practice address
312 MASS AVE, LUNENBURG, MA 01462-1219
(978) 582-0800
(978) 582-6400
Mailing address
312 MASS AVE, LUNENBURG, MA 01462-1219
(978) 582-0800
(978) 582-6400

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9793992
MA
Enumeration date
03/27/2008
Last updated
03/27/2008
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