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NPI Code Detail

MEDICARE: DR. HASSAN ATALLAH D.M.D.

MEDICARE: DR. HASSAN ATALLAH D.M.D.
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
11223G0001XGeneral Practice Dentistry20078MA

General Provider Information

NPI Number : 1710018718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HASSAN ATALLAH D.M.D.
Provider Business Mailing Address
First Line : 158 LAFAYETTE ST
Second Line :
City : SALEM
State : MA
Zip : 01970-4815
Country : US
Telephone Number : 978-744-4224
Fax Number : 978-744-5215
Provider Business Practice Location Address
First Line : 158 LAFAYETTE ST
Second Line :
City : SALEM
State : MA
Zip : 01970-4815
Country : US
Telephone Number : 978-744-4224
Fax Number : 978-744-5215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/08/2007

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