Dr. Mansour Moheban, D.M.D.
Dentist, Periodontics in Northborough, MA. Individual provider (NPI-1).
NPI number1679632467
StatusActive
Last updated in NPPESFeb 25, 2008
Details
- NPI
- 1679632467
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mansour Moheban
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 7, 2006
- Last updated
- Feb 25, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | 11905 | MA | Yes |
Practice location
154 Main StNorthborough, MA 01532-1930
Phone 508-393-2522 · Fax 508-393-9782
Mailing address
154 Main StNorthborough, MA 01532-1930
Phone 508-393-2522 · Fax 508-393-9782
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