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General NPI Number Information
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NPI Number | 1982873469
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Entity Type | Organization
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Legal Business Name | ALLEN K. NIUKIAN D.M.D.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 521 MOUNT AUBURN ST SUITE 102
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City | WATERTOWN
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State | MA
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Zip | 02472-4191
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Country | US
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Telephone | 617-923-0706
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Fax | 617-923-0706
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Provider Business Mailing Address
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Address Line | 521 MOUNT AUBURN ST SUITE 102
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City | WATERTOWN
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State | MA
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Zip | 02472-4191
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Country | US
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Telephone | 617-923-0706
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Fax | 617-923-0706
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ALLEN K. NIUKIAN
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Credential | D.M.D.
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Telephone | 617-923-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20227
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License Number State | MA
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