| NPI | 1366744047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER ATHANASIOU Owner 617-489-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 20896) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |