| NPI | 1396811428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MICHAEL MEDEIROS President 508-993-8313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17163) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-02-27 |