| NPI | 1265760193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J. MORTELLITI President 781-836-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN13263) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2009-12-04 |