| NPI | 1093871469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN BOUTET Office Manager 413-786-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20289) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-12-28 |