| NPI | 1144369109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FICARELLI Owner 617-232-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA 12246) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |