Provider Demographics
NPI:1588115240
Name:PABANEY, AMMAR HUSSAIN (DMD)
Entity type:Individual
Prefix:
First Name:AMMAR
Middle Name:HUSSAIN
Last Name:PABANEY
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 1:33 SPIT BROOK RD # A2
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-6902
Mailing Address - Country:US
Mailing Address - Phone:603-809-7528
Mailing Address - Fax:
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-374-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04266122300000X
MADN1857452122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist