| NPI | 1396991089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN A. NOONAN Office Manager 617-267-7002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 16418) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |