| NPI | 1235968819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEETU BANSAL Owner 617-275-6306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 125K00000X Advanced Practice Dental Therapist |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2024-07-31 |