Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 20209 | MA |
NPI | 1003093246 |
---|---|
Provider Name | Dr. Patrick Faithi Assioun |
First Address | Milford, MA 01757-2605 |
Second Address | Milford, MA 01757-2605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2008 |
Last Update Date | 19/02/2016 |