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General NPI Number Information
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NPI Number | 1417790494
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Entity Type | Organization
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Legal Business Name | MOSTAFAVIAN ORTHODONTICS P.C.
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 661 FRANKLIN ST UNIT 102
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City | FRAMINGHAM
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State | MA
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Zip | 01702-2900
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Country | US
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Telephone | 617-710-3345
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Fax |
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Provider Business Mailing Address
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Address Line | 661 FRANKLIN ST UNIT 102
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City | FRAMINGHAM
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State | MA
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Zip | 01702-2900
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Country | US
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Telephone | 617-710-3345
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SADAF MOSTAFAVIAN
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Credential | DMD
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Telephone | 617-710-3345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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