Provider Demographics
NPI:1720715394
Name:KHAYAT, AFAF A (DDS, MSD, CAGS)
Entity Type:Individual
Prefix:
First Name:AFAF
Middle Name:A
Last Name:KHAYAT
Suffix:
Gender:F
Credentials:DDS, MSD, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FIRST ST STE 17
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142-1292
Mailing Address - Country:US
Mailing Address - Phone:617-892-8245
Mailing Address - Fax:
Practice Address - Street 1:245 FIRST ST STE 17
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142-1292
Practice Address - Country:US
Practice Address - Phone:617-892-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL152171223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics