| NPI | 1275577058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM LEVINE Doctor 781-860-9473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 21310) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-08-22 |