| NPI | 1033659438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRAM MOGHADDAM Owner/Dentist 508-620-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 18767) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-03 |