Provider Demographics
NPI:1790506012
Name:ZEBOUNI, ALBERT JOSEPH
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:JOSEPH
Last Name:ZEBOUNI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 HARRISON AVE UNIT 227C
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2874
Mailing Address - Country:US
Mailing Address - Phone:617-595-3600
Mailing Address - Fax:
Practice Address - Street 1:460 HARRISON AVE UNIT 227C
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2874
Practice Address - Country:US
Practice Address - Phone:617-595-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics