Individual
DR. EJAZ ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5 SEAWARD RD, WELLESLEY, MA 02481-7510
(781) 237-9071
Mailing address
5 SEAWARD RD, WELLESLEY, MA 02481-7510
(781) 237-9071
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18473
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11612
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/22/2007
Last updated
07/08/2007
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