| NPI | 1316370075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUY NHU PHAM Vice President, Board Of Director 617-750-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |