| NPI | 1285884718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRAM GHAFGHAZI President 617-605-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA DE00010518) |
| Enumeration Date | 2008-09-20 |
| Last Update Date | 2008-09-20 |