| 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 |