| NPI | 1164668190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALYN H. DO Dentist 978-777-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 17543) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 10000) |
| 122300000X Dentist (Licence: MA 21321) | |
| 1223E0200X Dentist, Endodontics (Licence: MA 11064) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 8910) | |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |