| NPI | 1265692644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIJSBERTUS BRANDSE Dentist 508-650-7641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 19478) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |