| NPI | 1235145442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S FAHEEM RASOOL Owner 617-734-8599 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: MA 18801) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| 1223P0700X Dentist Prosthodontics | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-02-17 |