| NPI | 1275904682 | 
|---|---|
| Other Name | WATER STREET FAMILY DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | ALICIA LOPEZ- CASADO Regional Manager 978-372-1999 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857078) | 
| Enumeration Date | 2015-10-12 | 
| Last Update Date | 2015-10-12 |