| NPI | 1154564490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOS KOUMOUTSEAS Dentist/ Owner 617-929-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17622) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |