| NPI | 1295971992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE PONTE PEREIRA President 617-492-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: MA 17461) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2008-12-30 |