| NPI | 1063971281 |
|---|---|
| Doing Business As | LIGHTHOUSE PEDIATRIC DENTAL TEAM |
| Entity Type | Organization |
| Authorized Contact | PAYAM AMIRSAYAFI Owner 617-943-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |