41 State Rd, LLC
Dentist, Periodontics in North Dartmouth, MA. Organization (NPI-2).
NPI number1144701020
StatusActive
Last updated in NPPESNov 15, 2024
Details
- NPI
- 1144701020
- Entity type
- Organization (NPI-2)
- Legal business name
- 41 State Rd, LLC
- Organization subpart
- No
- Enumeration date
- Aug 28, 2018
- Last updated
- Nov 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | DN1856413 | MA | Yes |
Other names
- Dartmouth Periodontics And Implant Dentistry (Doing Business As)
Practice location
1379 Tucker RoadNorth Dartmouth, MA 02747
Phone 508-993-9105 · Fax 508-993-9115
Mailing address
1379 Tucker RoadNorth Dartmouth, MA 02747
Phone 508-993-9105 · Fax 508-993-9115
Authorized official
Mahmoud Hamad
Periodontist/Owner
5089939105
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