| NPI | 1225546567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE HODGERNEY Operations Manager 508-589-8270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 011318) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2019-05-24 |