Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DL12098 | MA |
NPI | 1083038699 |
---|---|
Provider Name | Sarah Almotlag |
First Address | Boston, MA 02111-1527 |
Second Address | Boston, MA 02111-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2014 |
Last Update Date | 18/02/2014 |