Provider Demographics
NPI:1740564418
Name:AIM DENTAL ,P.C.
Entity Type:Organization
Organization Name:AIM DENTAL ,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAQ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:774-258-0385
Mailing Address - Street 1:19 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2906
Mailing Address - Country:US
Mailing Address - Phone:774-258-0385
Mailing Address - Fax:
Practice Address - Street 1:19 HIGH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2906
Practice Address - Country:US
Practice Address - Phone:774-258-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN223391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty