| NPI | 1104205707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SUDATI General Partner 603-627-1301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NH 03648) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |