| NPI | 1346543014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL CHAN President 617-471-8161 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 20385) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2023-10-02 |