Provider Demographics
NPI:1821365479
Name:OH, BINA (DMD)
Entity Type:Individual
Prefix:
First Name:BINA
Middle Name:
Last Name:OH
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 1:152 LINCOLN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3832
Mailing Address - Country:US
Mailing Address - Phone:781-728-5455
Mailing Address - Fax:
Practice Address - Street 1:152 LINCOLN RD STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3832
Practice Address - Country:US
Practice Address - Phone:781-728-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18559871223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics