| NPI | 1093069858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE LANE Assistant Dean Of Clinical Operatio 617-432-4276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DF10843) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |