| NPI | 1093195232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK FRANK NAFASH Dental Director 617-634-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA DN1856376) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |