NPI | 1164651550 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN DOUGLAS BLISSETT Prosthodontist 617-738-1950 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 21630) |
Enumeration Date | 2009-07-07 |
Last Update Date | 2009-07-07 |