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General NPI Number Information
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NPI Number | 1861689309
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Entity Type | Individual
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Provider Name | IHAM GAMMAS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 550 N MAIN ST A
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City | ATTLEBORO
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State | MA
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Zip | 02703-1735
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Country | US
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Telephone | 508-222-2510
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Fax |
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Provider Business Mailing Address
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Address Line | 263 HUNTINGTON AVE 146
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City | BOSTON
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State | MA
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Zip | 02115-4506
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Country | US
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Telephone | 617-710-5072
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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 | 21981
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License Number State | MA
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