| NPI | 1295279073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN KELSEY MAY Manager 617-738-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA DN1857083) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-22 |