Provider Demographics
NPI:1598902421
Name:NOVID, SEPIDEH FOULADI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SEPIDEH
Middle Name:FOULADI
Last Name:NOVID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3508
Mailing Address - Country:US
Mailing Address - Phone:617-968-8607
Mailing Address - Fax:
Practice Address - Street 1:4 LAUREL ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-3508
Practice Address - Country:US
Practice Address - Phone:617-968-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist