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 |