| NPI | 1114147618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY WOOD Office Manager 617-923-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 18376) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |