Healthcare Provider Details

I. General information

NPI: 1376052282
Provider Name (Legal Business Name): ALEPMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SUMMER ST STE 11
HAVERHILL MA
01830-6305
US

IV. Provider business mailing address

210 BELMONT ST APT 5
WATERTOWN MA
02472-3557
US

V. Phone/Fax

Practice location:
  • Phone: 978-372-9122
  • Fax: 978-372-6131
Mailing address:
  • Phone: 857-272-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HASSAN JOHN ABOUKHATER
Title or Position: DENTIST
Credential: DMD
Phone: 857-272-0616