| NPI | 1366757064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHLEEN E. WALLENT Dentist 978-682-2276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 17997) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2010-09-14 |