| NPI | 1124135439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOHA ANAN ELKADRY President 781-729-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: MA 18623) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-08-29 |