Luminous Dentistry LLC
Clinic/Center, Dental in Wakefield, MA. Organization (NPI-2).
NPI number1710692702
StatusActive
Last updated in NPPESJan 13, 2023
Details
- NPI
- 1710692702
- Entity type
- Organization (NPI-2)
- Legal business name
- Luminous Dentistry LLC
- Organization subpart
- No
- Enumeration date
- Jan 13, 2023
- Certification date
- Jan 13, 2023
- Last updated
- Jan 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
544 Salem StWakefield, MA 01880-6245
Phone 201-417-8417
Mailing address
544 Salem StWakefield, MA 01880-6245
Phone 201-417-8417
Authorized official
Mohammed Baseer Ahmed
Dentist
2014178417
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