Provider Demographics
NPI:1265725501
Name:ALGHANEM, TOFOOL (BDS, MS, DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:TOFOOL
Middle Name:
Last Name:ALGHANEM
Suffix:
Gender:F
Credentials:BDS, MS, DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LINCOLN ST UNIT 213
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2610
Mailing Address - Country:US
Mailing Address - Phone:857-350-6546
Mailing Address - Fax:
Practice Address - Street 1:1 KNEELAND STREET 15 FLOOR
Practice Address - Street 2:ORTHODONTIC DEPARTMENT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18569391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics