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Organization

MELROSE FAMILY DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAAEDDIN ALWAZZAN DMD, FACP (OWNER)
(617) 669-9839
Entity
Organization

Contact information

Practice address
12 PORTER ST, MELROSE, MA 02176-2810
(781) 665-1552
Mailing address
12 PORTER ST, MELROSE, MA 02176-2810
(781) 665-1552

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN13354
MA
122300000X
Dentist
DN1855140
MA
1223P0700X
Prosthodontics
Primary
DN22162
MA

Other

Enumeration date
10/14/2016
Last updated
10/14/2016
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