| NPI | 1194939223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY M. DECOTEAU President 978-448-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 16575) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |