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General NPI Number Information
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NPI Number | 1073852901
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Entity Type | Organization
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Legal Business Name | SAM KHAYAT DMD PC
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 210 WHITING ST SUITE 1
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City | HINGHAM
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State | MA
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Zip | 02043-3724
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Country | US
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Telephone | 781-749-6050
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Fax | 781-749-2201
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Provider Business Mailing Address
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Address Line | 210 WHITING ST SUITE 1
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City | HINGHAM
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State | MA
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Zip | 02043-3724
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Country | US
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Telephone | 781-749-6050
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Fax | 781-749-2201
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMER KHAYAT
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Credential |
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Telephone | 617-416-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN1855820
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License Number State | MA
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