Provider Demographics
NPI:1053974295
Name:EID, FADY GEORGES (DMD, DSCD, MSED)
Entity type:Individual
Prefix:DR
First Name:FADY
Middle Name:GEORGES
Last Name:EID
Suffix:
Gender:M
Credentials:DMD, DSCD, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 CONSTITUTION AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1137
Mailing Address - Country:US
Mailing Address - Phone:978-501-2222
Mailing Address - Fax:978-501-2222
Practice Address - Street 1:802 CONSTITUTION AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1137
Practice Address - Country:US
Practice Address - Phone:978-501-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858595122300000X, 1223P0300X
PADS042320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist