| NPI | 1114326402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS ABBOUD Co Owner 617-893-9329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2014-08-22 |