Healthcare Provider Details

I. General information

NPI: 1003748906
Provider Name (Legal Business Name): MNK DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 MAIN ST
MAYNARD MA
01754-2506
US

IV. Provider business mailing address

14 MAIN ST
MAYNARD MA
01754-2506
US

V. Phone/Fax

Practice location:
  • Phone: 978-897-6399
  • Fax:
Mailing address:
  • Phone: 978-897-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NABIL Z KHAN
Title or Position: DENTIST
Credential: DDS
Phone: 978-897-6399