| NPI | 1164557161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYNE STEVEN JOHNSON Owner 508-994-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: MA MA16753) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |