| NPI | 1306004254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A TINKHAM Manager 508-761-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 16514) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |