Healthcare Provider Details

I. General information

NPI: 1235466764
Provider Name (Legal Business Name): HORIZON DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 BRIDGE ST
NORTH WEYMOUTH MA
02191-1457
US

IV. Provider business mailing address

471 BRIDGE ST P.O.BOX 99
NORTH WEYMOUTH MA
02191-1457
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-0500
  • Fax:
Mailing address:
  • Phone: 781-337-0500
  • 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. RANIA S MEHANNA
Title or Position: DENTIST
Credential: DMD
Phone: 781-337-0500