| NPI | 1366695991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE R. PETERS Practice Manager 617-523-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19464) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |