| NPI | 1407182033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND JOSEPH RUDDY CFO 508-505-7981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010025) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2022-09-26 |