Abdennour, Mario E

Abdennour, Mario E is an individual health care provider with primary practice located at 188 Longwood Ave , Boston MA 02115. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Abdennour, Mario E can be contacted via phone (978) 505-1969.

Contact Information

Primary practice address
188 Longwood Ave Boston MA 02115
Fax: (978) 688-6465
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 19242 Massachusetts
Dental Providers / Endodontics 1223E0200X 3244 New Hampshire

Profile Details

NPI number 1689749574
LBN Legal business name Abdennour, Mario E
Credentials DMD MMSC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 24th, 2006
Last updated Oct 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689749574 NPPES
Massachusetts Other X11812 BLUE CROSS & BLUE SHIELD

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