Healthcare Provider Details

I. General information

NPI: 1407546658
Provider Name (Legal Business Name): NAILA I USMANI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WALL ST
ATTLEBORO MA
02703-2853
US

IV. Provider business mailing address

1 WALL ST
ATTLEBORO MA
02703-2853
US

V. Phone/Fax

Practice location:
  • Phone: 774-203-3757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1859844
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: