Provider Demographics
NPI:1437616976
Name:MONSON FAMIY DENTAL
Entity Type:Organization
Organization Name:MONSON FAMIY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABU BAKER
Authorized Official - Middle Name:OBAID
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-275-2852
Mailing Address - Street 1:80 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-1318
Mailing Address - Country:US
Mailing Address - Phone:413-275-2852
Mailing Address - Fax:
Practice Address - Street 1:80 MAIN ST
Practice Address - Street 2:
Practice Address - City:MONSON
Practice Address - State:MA
Practice Address - Zip Code:01057-1318
Practice Address - Country:US
Practice Address - Phone:413-275-2852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental