Provider Demographics
NPI:1083944680
Name:FERAS AWAD, DDS, PC
Entity Type:Organization
Organization Name:FERAS AWAD, DDS, PC
Other - Org Name:MATTAPOISETT FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-758-6913
Mailing Address - Street 1:61 COUNTY RD
Mailing Address - Street 2:P.O. BOX 1389
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1652
Mailing Address - Country:US
Mailing Address - Phone:508-758-6913
Mailing Address - Fax:
Practice Address - Street 1:61 COUNTY RD
Practice Address - Street 2:
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-1652
Practice Address - Country:US
Practice Address - Phone:508-758-6913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty