Individual
ABDULLAH OTHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
879 MAIN ST, WALTHAM, MA 02451-7414
(781) 850-2361
Mailing address
879 MAIN ST, WALTHAM, MA 02451-7414
(781) 850-2361
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN1858871
MA
Other
Enumeration date
07/08/2015
Last updated
01/25/2021
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