Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | ETN286 | TX |
Y | 1223P0300X | Periodontist | DN1857536 | MA |
N | 1223P0300X | Periodontist | DN20632 | FL |
NPI | 1083023113 |
---|---|
Provider Name | Dr. Daniel Isaac Sabra |
First Address | Swampscott, MA 01907-2542 |
Second Address | Swampscott, MA 01907-2542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2014 |
Last Update Date | 13/04/2017 |