Individual
OMAR ALKHATTAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
72 E CONCORD ST RM 318, BOSTON, MA 02118-2307
(617) 223-7206
Mailing address
72 E CONCORD ST RM 318, BOSTON, MA 02118-2307
(617) 223-7206
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
13798
MA
1223G0001X
General Practice Dentistry
Primary
13798
MA
Other
Enumeration date
09/10/2018
Last updated
04/17/2019
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