| NPI | 1275076598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XIAOZHE HAN Manager 617-838-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 18785) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MA 22167) |
| 261QD0000X Clinic/Center, Dental (Licence: MA 21577) | |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2016-11-18 |