Healthcare Provider Details

I. General information

NPI: 1255527099
Provider Name (Legal Business Name): QUALITY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255B HANCOCK ST
QUINCY MA
02169-4342
US

IV. Provider business mailing address

1255B HANCOCK ST
QUINCY MA
02169-4342
US

V. Phone/Fax

Practice location:
  • Phone: 617-773-4144
  • Fax: 617-773-4149
Mailing address:
  • Phone: 617-773-4144
  • Fax: 617-773-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number21022
License Number StateMA

VIII. Authorized Official

Name: DR. ZAHER HAMMOUD
Title or Position: OWNER
Credential: DMD
Phone: 617-773-4144