Provider Demographics
NPI:1578307062
Name:AWADI ENDO PC
Entity type:Organization
Organization Name:AWADI ENDO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:W
Authorized Official - Last Name:AWADI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-934-4357
Mailing Address - Street 1:661 FRANKLIN ST # 102
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:661 FRANKLIN ST # 102
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2900
Practice Address - Country:US
Practice Address - Phone:617-678-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty