NPI | 1336792977 |
---|---|
Other Name | DETAIL DENTAL, LLC |
Former Legal Business Name | DETAIL DENTAL |
Entity Type | Organization |
Authorized Contact | CHRIS CHRISLER Owner 617-617-9644 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-07-23 |
Last Update Date | 2019-11-20 |