Provider Demographics
NPI:1841632213
Name:KAMEL, MOHAMAD (DMD)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:KAMEL
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 1:3033 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1227
Mailing Address - Country:US
Mailing Address - Phone:508-904-1530
Mailing Address - Fax:617-541-2206
Practice Address - Street 1:3033 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1227
Practice Address - Country:US
Practice Address - Phone:508-904-1530
Practice Address - Fax:617-541-2206
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029570122300000X
MADN1856303122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist