| NPI | 1407939879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA JOANNA PRONCZUK President 781-834-8969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20049) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2020-08-22 |