NPI | 1053823401 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID ROBERT BEANLAND Owner 978-392-9095 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DN20791) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DN21506) |
204E00000X Oral & Maxillofacial Surgery (Licence: MA DN1855623) | |
Enumeration Date | 2017-10-25 |
Last Update Date | 2017-10-25 |