Provider Demographics
NPI:1013034693
Name:SURABIAN, GEORGE ARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARA
Last Name:SURABIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3521
Mailing Address - Country:US
Mailing Address - Phone:781-665-2113
Mailing Address - Fax:
Practice Address - Street 1:10 E EMERSON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3521
Practice Address - Country:US
Practice Address - Phone:781-665-2113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice