Individual
EHAB TALAL AZAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6531
Mailing address
160 PLEASANT ST APT 303, MALDEN, MA 02148-4833
(857) 399-3594
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DL11378
MA
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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