| NPI | 1265836035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE BERUBE REDDSIH Dentist 617-290-6944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20440m) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |