Ali Anwar Aboalela

Individual provider Active NPI Oral and Maxillofacial Pathology Dentistry · Boston, MA

NPI 1356773642 · NPPES record last updated Aug 8, 2013

Key facts

NPI
1356773642
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Pathology Dentistry 1223P0106X
License
DL11825 (MA)
Practice address
75 Francis Street
Brigham and Womens Hospital
Boston, MA 02115
Phone
(617) 732-6974
NPI assigned
Aug 8, 2013
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
DL11825MAMDOral and Maxillofacial Pathology Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X DL11825 MA Yes

Addresses

Primary practice location

75 Francis Street
Brigham and Womens Hospital
Boston, MA 02115

Mailing address

151 Tremont St
Apt 17B
Boston, MA 02111-1125
Phone (617) 515-9993

Other providers in Boston, MA

All providers in Boston, MA · Oral and Maxillofacial Pathology Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.