| NPI | 1164077152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J. FEIDER Owner 781-599-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |