Provider Demographics
NPI:1104380526
Name:SFRNSH LLC
Entity Type:Organization
Organization Name:SFRNSH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NARGUESS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-734-8599
Mailing Address - Street 1:1199 BEACON ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5352
Mailing Address - Country:US
Mailing Address - Phone:617-734-8599
Mailing Address - Fax:
Practice Address - Street 1:209 HARVARD ST STE 302
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5005
Practice Address - Country:US
Practice Address - Phone:617-566-4108
Practice Address - Fax:617-566-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty