Individual provider · NPI-1

Dr. Mario E Abdennour, DMD MMSc

Dentist, Endodontics · Boston, MA

NPI number1689749574
StatusActive
Last updated in NPPESOct 17, 2007

Details

NPI
1689749574
Entity type
Individual (NPI-1)
Name
Dr. Mario E Abdennour
Credential
DMD MMSc
Sex
Male
Sole proprietor
No
Enumeration date
Nov 24, 2006
Last updated
Oct 17, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223E0200X Dentist, Endodontics19242MAYes
1223E0200X Dentist, Endodontics3244NH

Practice location

188 Longwood Ave
Boston, MA 02115

Phone 978-505-1969 · Fax 978-688-6465

Mailing address

75 Thistle Rd
North Andover, MA 01845-4745

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