| NPI | 1093723074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY TALBOT HODGE President 781-545-3466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 18070) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |