| NPI | 1316303324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH CONANT Director Of Finance And Administrat 617-636-6842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DF11049) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |