| NPI | 1053608083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINA AMY ILIEF-ALA President 781-859-8677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN21806) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |