| NPI | 1376953901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL ARTHUR BLACK President 617-875-3293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401412426) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |