| NPI | 1225348428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL A HABIB Manager 508-679-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1855087) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1855087) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |