Healthcare Provider Details

I. General information

NPI: 1629923552
Provider Name (Legal Business Name): GASER ABDELAZIZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GASER O. ABDELAZIZ DMD

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

156 HARVARD ST APT 8
BROOKLINE MA
02446-6452
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2740
  • Fax:
Mailing address:
  • Phone: 617-331-9069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10001193
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: