Provider Demographics
NPI:1568821361
Name:AHMED HAMADA DMD PC
Entity Type:Organization
Organization Name:AHMED HAMADA DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMADA IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:857-540-0135
Mailing Address - Street 1:3 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01560-1228
Mailing Address - Country:US
Mailing Address - Phone:857-540-0135
Mailing Address - Fax:
Practice Address - Street 1:209 SUMMER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6319
Practice Address - Country:US
Practice Address - Phone:978-373-1231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18561781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty