Provider Demographics
NPI:1093120081
Name:ALSHAWAF, BAHAA M M A A M A (DDS)
Entity Type:Individual
Prefix:MR
First Name:BAHAA
Middle Name:M M A A M A
Last Name:ALSHAWAF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 KNEELAND STREET
Mailing Address - Street 2:TUFTS UNIVERSITY-SCHOOL OF DENTAL MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-6641
Mailing Address - Fax:617-636-0309
Practice Address - Street 1:1 KNEELAND STREET
Practice Address - Street 2:TUFTS UNIVERSITY-SCHOOL OF DENTAL MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-6641
Practice Address - Fax:617-636-0309
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program