MEDICARE: DR. POOYAN REFAHI D.M.D, M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	DN1857015	MA

General Provider Information

NPI Number	:	1518349810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POOYAN REFAHI D.M.D, M.S.

Provider Business Mailing Address
First Line	:	45 RESNIK RD STE 304
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4883
Country	:	US
Telephone Number	:	508-927-1486
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 RESNIK RD STE 304
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4883
Country	:	US
Telephone Number	:	508-927-1486
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	03/07/2026

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