| NPI | 1124173612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D CARR Owner 617-262-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA 11712) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |