| NPI | 1326249616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN JOSEPH COSTANZA Orthodontist 1978-774-8266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 8910) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |