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General NPI Number Information
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NPI Number | 1750886685
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Entity Type | Organization
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Legal Business Name | AMERICAN DENTAL OF WATERTOWN
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 171 WATERTOWN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2571
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Country | US
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Telephone | 617-467-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 171 WATERTOWN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2571
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Country | US
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Telephone | 617-467-5113
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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. SAIF NAJI
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Credential | DMD
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Telephone | 617-467-5113
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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 | DN1855991
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License Number State | MA
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