Provider Demographics
NPI:1730837493
Name:TAHER FAMILY DENTAL LLC
Entity type:Organization
Organization Name:TAHER FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-835-2525
Mailing Address - Street 1:32 W BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1710
Mailing Address - Country:US
Mailing Address - Phone:508-835-2525
Mailing Address - Fax:
Practice Address - Street 1:32 W BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1710
Practice Address - Country:US
Practice Address - Phone:508-835-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental