Provider Demographics
NPI:1225301237
Name:ABDULLAH, ASMA
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 BOSTON TPKE APT 4
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3917
Mailing Address - Country:US
Mailing Address - Phone:215-847-2069
Mailing Address - Fax:
Practice Address - Street 1:469 BOSTON TPKE
Practice Address - Street 2:APT #4
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3917
Practice Address - Country:US
Practice Address - Phone:215-847-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18558741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice