Organization
DAVIS SQUARE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOUHAB RIZKALLAH (PRESIDENT)
(617) 872-4499
Entity
Organization
Contact information
Practice address
30 COLLEGE AVE, SUITE 300, SOMERVILLE, MA 02144-1914
(617) 764-2247
Mailing address
30 COLLEGE AVE, SOMERVILLE, MA 02144-1914
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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