| NPI | 1184365942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAAEDDIN ALWAZZAN President 617-669-9839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |