Individual
DR. ABDULAZIZ FAHAD BANASR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(929) 318-7874
Mailing address
449 CANAL ST APT 1210, SOMERVILLE, MA 02145-4377
(929) 318-7874
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/09/2019
Last updated
11/09/2019
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