Marc Bou-Abboud, DMD

Individual provider Active NPI General Practice Dentistry · Lunenburg, MA

NPI 1245890722 · NPPES record last updated Jun 18, 2019

Key facts

NPI
1245890722
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN1858269 (MA)
Practice address
40 Massachusetts Ave
Lunenburg, MA 01462-1248
Phone
(978) 401-0221
NPI assigned
Jun 18, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN1858269MAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1858269 MA Yes

Addresses

Primary practice location

40 Massachusetts Ave
Lunenburg, MA 01462-1248

Mailing address

24 Middlesex Cir Apt 3
Waltham, MA 02452-6264
Phone (304) 673-5493

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Brightsquid

Other providers in Lunenburg, MA

All providers in Lunenburg, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.