Individual
DR. MOHAMMED MOEEDUDDIN AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MDS
Contact information
Practice address
61 PINE ST, BRISTOL, VT 05443-1043
(802) 453-3911
Mailing address
26 GREENWICH ST, BOSTON, MA 02120-2202
(331) 980-2703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.0134053
VT
1223X2210X
Orofacial Pain Dentistry
019.0134053
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6710467
—
VT
Enumeration date
06/14/2022
Last updated
08/16/2022
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