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General NPI Number Information
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NPI Number | 1659880409
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Entity Type | Individual
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Provider Name | JAMES ASSAD DMD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 1 AYRES CIRCLE
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City | KITTERY
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State | ME
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Zip | 03904
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Country | US
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Telephone | 207-438-1714
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Fax |
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Provider Business Mailing Address
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Address Line | 337 SAVANNAH HWY APT 835
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City | BEAUFORT
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State | SC
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Zip | 29906-6771
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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 |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9021
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License Number State | SC
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