| NPI | 1104243674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHAZWAN F. GHAZI Owner/President 508-771-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 18265) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |