| NPI | 1245549203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBINA ALI Owner 617-335-8334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 9436) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 009436) |
| 122300000X Dentist (Licence: CT 009576) | |
| 1223P0300X Dentist, Periodontics (Licence: CT 010145) | |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2013-05-03 |