Provider Demographics
NPI:1750647327
Name:IEBBA, ARMAND A (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARMAND
Middle Name:A
Last Name:IEBBA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 ASH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3166
Mailing Address - Country:US
Mailing Address - Phone:781-944-6761
Mailing Address - Fax:781-942-1788
Practice Address - Street 1:161 ASH ST
Practice Address - Street 2:SUITE B
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3166
Practice Address - Country:US
Practice Address - Phone:781-944-6761
Practice Address - Fax:781-942-1788
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-07
Last Update Date:2012-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16251122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist