| NPI | 1043256621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMAND SHAIBANI Dentist 781-221-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19601) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 19460) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-08-22 |