| NPI | 1295024073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVANA ADAMOV Dentist 617-471-8640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN21465) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2011-04-01 |