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General NPI Number Information
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NPI Number | 1922379817
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Entity Type | Individual
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Provider Name | SHILA SHARIFI DMD, MSC, CAGS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 488 ESSEX ST
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City | LAWRENCE
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State | MA
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Zip | 01840-1242
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Country | US
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Telephone | 978-975-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 488 ESSEX ST
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City | LAWRENCE
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State | MA
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Zip | 01840-1242
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Country | US
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Telephone | 978-975-8888
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN 1855539
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License Number State | MA
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