Organization
GREAT WOODS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAHID MISTIKAWI D.M.D. (OWNER/DOCTOR)
(508) 339-4171
Entity
Organization
Contact information
Practice address
792 S MAIN ST, SUITE 24, MANSFIELD, MA 02048-3137
(508) 339-4171
(508) 339-4171
Mailing address
792 S MAIN ST, SUITE 24, MANSFIELD, MA 02048-3137
(508) 339-4171
(508) 339-8311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17639
MA
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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