| NPI | 1326171109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIS W WITT President 508-829-7650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 17900) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-23 |