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General NPI Number Information
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NPI Number | 1770433732
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Entity Type | Organization
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Legal Business Name | PLYMOUTH PERIO PLLC
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 45 RESNIK RD STE 304
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City | PLYMOUTH
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State | MA
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Zip | 02360-4883
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Country | US
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Telephone | 508-927-1486
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Fax |
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Provider Business Mailing Address
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Address Line | 128 SUMNER ST
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City | MILTON
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State | MA
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Zip | 02186-2555
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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 | OWNER
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Name | SAMAR SHAIKH
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Credential | DMD
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Telephone | 508-927-1486
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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 |
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License Number State |
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