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General NPI Number Information
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NPI Number | 1356157820
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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 | 12/09/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 344 GIFFORD ST UNIT A
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City | FALMOUTH
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State | MA
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Zip | 02540-5109
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Country | US
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Telephone | 508-524-3732
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Fax |
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Provider Business Mailing Address
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Address Line | 344 GIFFORD ST UNIT A
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City | FALMOUTH
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State | MA
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Zip | 02540-5109
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Country | US
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Telephone | 508-524-3732
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABDUL RAHMAN ADDAS ADDAS
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Credential | DMD
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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