| NPI | 1194926543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL CHAN President 781-545-5102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 20385) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |