| NPI | 1346083995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY LONABOCKER Vice President Strategy & Operation 508-345-7059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |