| NPI | 1083124895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLIN WEAVER Owner 781-581-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1856790) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |