Provider Demographics
NPI:1205964749
Name:R A NOOR DMD PC
Entity type:Organization
Organization Name:R A NOOR DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RASHID
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-695-1903
Mailing Address - Street 1:90 ORNE ST
Mailing Address - Street 2:
Mailing Address - City:N ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6328
Mailing Address - Country:US
Mailing Address - Phone:508-695-1903
Mailing Address - Fax:508-699-5913
Practice Address - Street 1:90 ORNE ST
Practice Address - Street 2:
Practice Address - City:N ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6328
Practice Address - Country:US
Practice Address - Phone:508-695-1903
Practice Address - Fax:508-699-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
MA18506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI8009-3OtherRI BLUE CROSS PROVIDER ID
MAX11149OtherMA BLUE CROSS PROVIDER ID