| NPI | 1093093007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE M OSBORN Treasurer 617-571-1697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MA 10646) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |