Provider Demographics
NPI:1538333190
Name:PARISA SAFAEI DMD, PC
Entity Type:Organization
Organization Name:PARISA SAFAEI DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:PARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFAEI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-332-2872
Mailing Address - Street 1:825 BEACON ST STE 16
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1834
Mailing Address - Country:US
Mailing Address - Phone:617-332-2872
Mailing Address - Fax:617-332-9446
Practice Address - Street 1:825 BEACON ST STE 16
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-1834
Practice Address - Country:US
Practice Address - Phone:617-332-2872
Practice Address - Fax:617-332-9446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty