| NPI | 1265568174 |
|---|---|
| Doing Business As | BACK BAY ORAL& MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | MAHMOUD A EL HADIDY President 617-267-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MA 19353) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |