Organization
QUINCY HIGH CARE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOATAZ MOHAMMED SHABAN DMD (MANAGER)
(862) 588-6574
Entity
Organization
Contact information
Practice address
67 CODDINGTON ST, SUITE LL1, QUINCY, MA 02169-4511
(862) 588-6574
Mailing address
67 CODDINGTON ST, SUITE LL1, QUINCY, MA 02169-4511
(862) 588-6574
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN22158
MA
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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