Healthcare Provider Details

I. General information

NPI: 1073543005
Provider Name (Legal Business Name): RAMZI ANTOINE SARKIS DCHD DMD MSCD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAMZI ANTOUN SARKIS DCHD DMD MSCD

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 WALTHAM ST SUITE 204
LEXINGTON MA
02421-8019
US

IV. Provider business mailing address

922 WALTHAM ST SUITE 204
LEXINGTON MA
02421-8019
US

V. Phone/Fax

Practice location:
  • Phone: 781-325-8181
  • Fax:
Mailing address:
  • Phone: 781-325-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number20630
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: