| NPI | 1184850091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE GIARRUSSO President,Treasurer Cmoa, Pc 508-753-2489 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 17729) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |