| NPI | 1013366525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MILLER President 617-921-6292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 20980) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |