| NPI | 1124032099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R DORNBUSH Owner 781-639-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 13302) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |