Abdennour, Mario E
Abdennour, Mario E is an individual health care provider with primary practice located at 188 Longwood Ave , Boston MA 02115. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Abdennour, Mario E can be contacted via phone (978) 505-1969.Contact Information
Primary practice address
188 Longwood Ave
Boston MA 02115
Phone: (978) 505-1969
Fax: (978) 688-6465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 19242 | Massachusetts |
| Dental Providers / Endodontics | 1223E0200X | 3244 | New Hampshire |
Profile Details
| NPI number | 1689749574 |
|---|---|
| LBN Legal business name | Abdennour, Mario E |
| Credentials | DMD MMSC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 24th, 2006 |
| Last updated | Oct 17th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689749574 | NPPES |
| Massachusetts | Other | X11812 | BLUE CROSS & BLUE SHIELD |
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