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General NPI Number Information
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NPI Number | 1992935910
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Entity Type | Organization
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Legal Business Name | WESTON ENDODONTICS, LLC
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 56 COLPITTS RD
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City | WESTON
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State | MA
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Zip | 02493-1568
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Country | US
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Telephone | 508-875-5863
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Fax |
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Provider Business Mailing Address
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Address Line | 56 COLPITTS RD
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City | WESTON
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State | MA
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Zip | 02493-1568
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Country | US
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Telephone | 508-875-5863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AYMAN ABOUSHALA
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Credential | DMD, MS
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Telephone | 508-875-5863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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