NPI | 1033233713 |
---|---|
Entity Type | Organization |
Authorized Contact | BERDJ KILADJIAN Owner 617-566-5445 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223E0200X Dentist Endodontics |
1223P0106X Dentist Oral and Maxillofacial Pathology | |
1223P0300X Dentist Periodontics | |
1223P0700X Dentist Prosthodontics | |
124Q00000X Dental Hygienist | |
126800000X Dental Assistant | |
126900000X Dental Laboratory Technician | |
Enumeration Date | 2007-03-19 |
Last Update Date | 2020-08-22 |