| NPI | 1124199914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN O'MALLEY Office Manager 508-473-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 17118) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |