Provider Demographics
NPI:1437883311
Name:AKHTAR, TAHA M (BDS, CAGS)
Entity Type:Individual
Prefix:
First Name:TAHA
Middle Name:M
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:BDS, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 QUEEN STREET
Mailing Address - Street 2:
Mailing Address - City:WORCETSER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7910
Mailing Address - Fax:
Practice Address - Street 1:26 QUEEN STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-860-7910
Practice Address - Fax:508-860-7774
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADF118381223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics