| NPI | 1013153048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOPSARAN CHAIMATTAYOMPOL Director 617-782-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 20789) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |