| NPI | 1265596225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA DICICCO Manager 508-872-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 10578) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-08-29 |