| NPI | 1144346644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA GALLANT Office Manager 978-263-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 10905) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-03-28 |