| 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 |