Organization
ST MARK DENTAL PC
Active
Other names
family dental care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVEBAKHIT TADROS BAKHIT DMD (PRESIDENT)
(508) 533-7890
Entity
Organization
Contact information
Practice address
113 MAIN ST, NONE, MEDWAY, MA 02053-1802
(508) 533-7890
(508) 533-7890
Mailing address
113 MAIN ST, NONE, MEDWAY, MA 02053-1802
(508) 533-7890
(508) 533-7890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17758
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0273201
—
MA
Enumeration date
07/19/2006
Last updated
03/24/2015
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