| NPI | 1235494279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRAM MOGHADDAM Owner 781-331-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 18767) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |