| NPI | 1013587146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAISE C ECKERT Owner/Oral & Maxillofacial Surgeon 617-484-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-06-30 |