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General NPI Number Information
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NPI Number | 1790401123
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Entity Type | Individual
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Provider Name | NOOR AL-NOORI DMD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 30 ADDINGTON RD APT 2
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City | BROOKLINE
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State | MA
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Zip | 02445-4697
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Country | US
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Telephone | 713-480-3925
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Fax |
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Provider Business Mailing Address
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Address Line | 172 SPRING ST
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City | WEST ROXBURY
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State | MA
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Zip | 02132-5020
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Country | US
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Telephone | 617-323-5000
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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 | 859598
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License Number State | MA
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