| NPI | 1003128927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMER RAMADAN Director 617-323-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 21395) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 15388) |
| 1223G0001X Dentist, General Practice (Licence: MA 1855474) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |