| NPI | 1043696107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CHOINEIRE Billing Manager 508-879-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |