| NPI | 1336361930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA B GLICKSMAN Orthodontist President 781-449-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 19557) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |