Provider Demographics
NPI:1952611766
Name:MUFTU, ALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:MUFTU
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 1:465 WASHINGTON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6137
Mailing Address - Country:US
Mailing Address - Phone:617-444-9684
Mailing Address - Fax:617-636-6583
Practice Address - Street 1:1 KNEELAND ST
Practice Address - Street 2:DHS 456
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-2183
Practice Address - Fax:617-636-6583
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN205151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics