| NPI | 1093848533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLLY PROHOVICH Office Manager 508-238-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 15891) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2018-04-19 |