| NPI | 1316915788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL PETRARCA President 781-391-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-01-16 |