| NPI | 1245743608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J GAUTHIER Manager/Owner 508-393-8819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN20814) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |