| NPI | 1265756423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN PUTT Owner 508-358-6108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19663) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |