Emad Fathi Abdallah, D.M.D., M.S.

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Dedham, MA

NPI 1851474324 · NPPES record last updated Jun 7, 2010

Key facts

NPI
1851474324
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
21655 (MA)
Practice address
107 Eastern Ave
Dedham, MA 02026-4515
Phone
(781) 350-1001
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 21655 MA Yes

Addresses

Primary practice location

107 Eastern Ave
Dedham, MA 02026-4515

Mailing address

72 Cedar Rd N
Medford, MA 02155-1906

Other providers in Dedham, MA

All providers in Dedham, MA · Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.