| NPI | 1053342972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ANTHONY RUSSO Partner 978-281-1337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20806) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 12116) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |