Organization
AUBURN ORAL SURGERY & IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAITH AZZOUNI (OWNER)
(508) 832-0919
Entity
Organization
Contact information
Practice address
390 SOUTHBRIDGE ST, AUBURN, MA 01501-2456
(508) 832-0919
(508) 832-0426
Mailing address
390 SOUTHBRIDGE ST, AUBURN, MA 01501-2456
(508) 832-0919
(508) 832-0426
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1855086
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN1856196
MA
Other
Enumeration date
02/26/2013
Last updated
09/30/2014
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