| NPI | 1275614349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL MARIE O'CONNELL Owmer 508-721-9558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19004) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |