| NPI | 1134331937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE DEL COPOLO Owner 617-773-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 13641) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI 2010) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |