NPI 1417399270

Wahid Mistikawi Dba Greatwoods Family Dentistry

Organisation Preferred Provider Organization Mansfield, MA

Practice location

Address: 792south Main St 24, Mansfield, MA 02048-3137
Phone: (508) 339-4171
Fax: (508) 339-8311
Mailing address: 792 S Main St, Mansfield, MA 02048-3137

Authorised official

Name: Wahid Mistikawi
Title: Dentist
Phone: (508) 339-4171

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence DN17639 (MA)

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Registry record

NPI: 1417399270
Entity type: Organization
NPI issued: 22 Jul 2013
Record last updated: 22 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.