| NPI | 1306395223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA LARSON President 617-913-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055413) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |