| NPI | 1164597217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHILBY D MALOUF Vice President 617-628-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 9637) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 9458) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |