NPI | 1275733263 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIAM GHAVAMIAN Owner 617-738-0806 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 18012) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2023-10-12 |