| NPI | 1275674939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ALBERT GAGNE President 508-839-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 10249) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |