Provider Demographics
NPI:1093454639
Name:ATTIA, SHERIF AHMED MOHAMED NOUR (DMD)
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:AHMED MOHAMED NOUR
Last Name:ATTIA
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 1:333 CHARLESTOWN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3355
Mailing Address - Country:US
Mailing Address - Phone:407-907-7410
Mailing Address - Fax:
Practice Address - Street 1:129 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2402
Practice Address - Country:US
Practice Address - Phone:508-754-5891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4633122300000X
390200000X
MADN1859477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program