| NPI | 1093008740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILJENKA BARLOW Dentist 617-717-9454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411561) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |