MEDICARE: DIANE ALHAFEZ

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	122300000X	Dentist	DN10000972	MA

General Provider Information

NPI Number	:	1760242630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE ALHAFEZ

Provider Business Mailing Address
First Line	:	635 ALBANY ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-3550
Country	:	US
Telephone Number	:	617-358-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	879 MAIN ST
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-7414
Country	:	US
Telephone Number	:	781-850-2361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	01/23/2026

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Directions to “ DIANE ALHAFEZ ” Practice Location

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