| NPI | 1184087058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE TAVANO COO 978-580-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |