| NPI | 1104088491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED E MOBASHERAT President 781-396-6613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 15376) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20309) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 13913) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |