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NPI Code Detail

MEDICARE: DR. MARIO GEORGE ABOUJAOUDE DDS

MEDICARE: DR. MARIO GEORGE ABOUJAOUDE DDS
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
11223G0001XGeneral Practice Dentistry19220MA

General Provider Information

NPI Number : 1962597237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIO GEORGE ABOUJAOUDE DDS
Provider Business Mailing Address
First Line : 1141 SOUTH ST
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-7038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1141 SOUTH ST
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-7029
Country : US
Telephone Number : 978-342-5313
Fax Number : 978-345-3518
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 09/14/2019

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