| NPI | 1003110909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD G CARLSON President 508-398-6939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA dn1855363) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |