| NPI | 1053074229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CAMPBELL CEO 617-863-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2023-04-13 |