Provider Demographics
NPI:1326160219
Name:ASPEN DENTAL ASSOCIATES OF NEW ENGLAND PC
Entity Type:Organization
Organization Name:ASPEN DENTAL ASSOCIATES OF NEW ENGLAND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-454-6000
Mailing Address - Street 1:PO BOX 3189
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13220-3189
Mailing Address - Country:US
Mailing Address - Phone:315-454-6000
Mailing Address - Fax:315-454-8650
Practice Address - Street 1:20 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-5823
Practice Address - Country:US
Practice Address - Phone:508-336-6700
Practice Address - Fax:508-336-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty