Provider Demographics
NPI:1225540776
Name:KHALID, LAILA (DMD)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:KHALID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 DIGITAL DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4577
Mailing Address - Country:US
Mailing Address - Phone:978-412-5954
Mailing Address - Fax:
Practice Address - Street 1:375 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1216
Practice Address - Country:US
Practice Address - Phone:508-265-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist