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General NPI Number Information
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NPI Number | 1396520508
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Entity Type | Individual
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Provider Name | THURAYA ELGREU
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Gender | Female
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 635 ALBANY ST
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City | BOSTON
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State | MA
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Zip | 02118-3550
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Country | US
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Telephone | 617-358-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 518 HILLTOP DR
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City | WALPOLE
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State | MA
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Zip | 02081-4409
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Country | US
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Telephone | 267-242-7892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 05326
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DL15801
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License Number State | MA
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