Provider Demographics
NPI:1841441649
Name:NAFASH, FREDERICK F (DMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:F
Last Name:NAFASH
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 1:100 E NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2308
Mailing Address - Country:US
Mailing Address - Phone:617-638-4762
Mailing Address - Fax:
Practice Address - Street 1:611 ADAMS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1319
Practice Address - Country:US
Practice Address - Phone:617-479-9191
Practice Address - Fax:617-481-6635
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18563761223P0300X
MADL114891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics