| NPI | 1003952839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS LIPOVETSKIY Dentist 508-270-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 18645) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |