Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DL14978 | MA |
NPI | 1194496208 |
---|---|
Provider Name | Dr. Maha Alenzi |
First Address | Boston, MA 02118-2821 |
Second Address | Boston, MA 02111-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2021 |
Last Update Date | 28/09/2021 |