| NPI | 1023425808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE DEPATIE Director Of Operations 508-754-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 20952) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |