MEDICARE: AMERICAN DENTAL OF QUINCY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1093372583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN DENTAL OF QUINCY PC

Provider Business Mailing Address
First Line	:	688 HANCOCK ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02170-2814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	688 HANCOCK ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02170-2814
Country	:	US
Telephone Number	:	415-314-6962
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAIF NAJI
Credential	:	DMD
Telephone Number	:	415-314-6962

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	05/21/2019

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