| NPI | 1396883211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BURNES Owner 617-277-3127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 16594) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 12349) |
| 1223G0001X Dentist, General Practice (Licence: MA 14810) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |