| NPI | 1225307572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN T KENNON President 508-823-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20724) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |