| NPI | 1407257207 |
|---|---|
| Doing Business As | CHILDREN'S DENTISTRY OF BROCKTON |
| Entity Type | Organization |
| Authorized Contact | JOANNE TAVANO Director 978-580-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MA 20209) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |