| NPI | 1104067669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P KOSMIDIS President 617-497-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 21156) |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2009-03-13 |