| NPI | 1417012964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE M POLANSKY President 781-444-2282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15057) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |