| NPI | 1407300015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND MASSABNI Owner 508-473-7632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA dn20694) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |