| NPI | 1356648075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAED YAZBECK Owner 508-567-4544 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 22252) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21657) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |