Healthcare Provider Details

I. General information

NPI: 1205964749
Provider Name (Legal Business Name): R A NOOR DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 ORNE ST
N ATTLEBORO MA
02760-6328
US

IV. Provider business mailing address

90 ORNE ST
N ATTLEBORO MA
02760-6328
US

V. Phone/Fax

Practice location:
  • Phone: 508-695-1903
  • Fax: 508-699-5913
Mailing address:
  • Phone: 508-695-1903
  • Fax: 508-699-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18506
License Number StateMA

VIII. Authorized Official

Name: RASHID A. NOOR
Title or Position: DENTIST
Credential: D.M.D.
Phone: 508-695-1903