Basic Information
| Provider Information | |||||||||
| NPI: | 1437883311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AKHTAR | ||||||||
| FirstName: | TAHA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | BDS, CAGS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 QUEEN STREET | ||||||||
| Address2: | |||||||||
| City: | WORCETSER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088607910 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 26 QUEEN STREET | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088607910 | ||||||||
| FaxNumber: | 5088607774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2022 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0700X | DF11838 | MA | Y | Dental Providers | Dentist | Prosthodontics |
No ID Information.