Provider Demographics
NPI:1992531008
Name:AL SHALTONI, REEM MOHAMAD (DDS, CAGS, MSD)
Entity type:Individual
Prefix:
First Name:REEM
Middle Name:MOHAMAD
Last Name:AL SHALTONI
Suffix:
Gender:F
Credentials:DDS, CAGS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 WASHINGTON ST APT 604
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3390
Mailing Address - Country:US
Mailing Address - Phone:703-362-4881
Mailing Address - Fax:
Practice Address - Street 1:930 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1274
Practice Address - Country:US
Practice Address - Phone:617-358-0529
Practice Address - Fax:617-358-1010
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADF1000221223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics