| NPI | 1023417250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE RYAN GRIFFITH President 617-861-5809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 00201927) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |