Healthcare Provider Details

I. General information

NPI: 1295757151
Provider Name (Legal Business Name): AKRAM E RAFLA, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUITE 102 1 EAST MAIN ST.
NORTHBORO MA
01532
US

IV. Provider business mailing address

SUITE 701 255 PARK AVE
WORCESTER MA
01609
US

V. Phone/Fax

Practice location:
  • Phone: 508-393-0160
  • Fax: 508-351-6900
Mailing address:
  • Phone: 508-363-4400
  • Fax: 508-363-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. AKRAM E RAFLA
Title or Position: DR.
Credential: BDS, DMD,
Phone: 508-363-4400