| NPI | 1073730297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MARK HAMELBURG Managing Partner 781-598-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17992) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 17953) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2016-11-09 |