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General NPI Number Information
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NPI Number | 1851106785
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Entity Type | Organization
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Legal Business Name | LOWELL KIDS DENTISTRY
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 10 GEORGE ST
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City | LOWELL
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State | MA
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Zip | 01852-2241
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Country | US
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Telephone | 857-707-5144
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Fax |
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Provider Business Mailing Address
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Address Line | 10 GEORGE ST
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City | LOWELL
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State | MA
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Zip | 01852-2241
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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 | DR
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Name | MARYAM MAGHSOUDLOO
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Credential |
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Telephone | 857-707-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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