| Professional Dental Image | |
|
53 Bigelow Ave Watertown MA 02472-2009 | |
| (248) 824-4916 | |
| Not Available |
| Full Name | Professional Dental Image |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 53 Bigelow Ave, Watertown, Massachusetts |
| Authorized Official Name and Position | Mustafa Zakkoom (DENTIST) |
| Authorized Official Contact | 2488244916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Image 770 Boylston St Apt 15h Boston MA 02199-7713 Ph: (248) 824-4916 | Professional Dental Image 53 Bigelow Ave Watertown MA 02472-2009 Ph: (248) 824-4916 |
| NPI Number | 1881105484 |
|---|---|
| Provider Enumeration Date | 10/23/2017 |
| Last Update Date | 10/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881105484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN1856872 (Massachusetts) | Primary |
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