| NPI | 1184887192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHIEM B PHAM-NGUYEN President 617-817-4577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 20940) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |