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General NPI Number Information
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NPI Number | 1053847426
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Entity Type | Organization
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Legal Business Name | AMG DENTAL GROUP PC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 303 DILLINGHAM AVE STE A
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City | FALMOUTH
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State | MA
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Zip | 02540-3376
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Country | US
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Telephone | 508-548-5028
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Fax |
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Provider Business Mailing Address
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Address Line | 245 JONES RD
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City | FALMOUTH
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State | MA
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Zip | 02540-2944
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. ABDUL-RAHMAN ADDAS
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Credential | D.M.D
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Telephone | 513-560-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN21001
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN18265
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN21722
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1856674
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License Number State | MA
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