Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 18488 | MA |
NPI | 1063585354 |
---|---|
Provider Name | Dr. Shadi Daher |
First Address | Westwood, MA 02090-1162 |
Second Address | Boston, MA 02116-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |