NPI | 1184346256 |
---|---|
Entity Type | Organization |
Authorized Contact | MINA CHOE BOUDREAU Owner 857-304-4153 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2022-09-15 |
Last Update Date | 2023-03-14 |