| NPI | 1417048117 |
|---|---|
| Other Name | S CORPORATION |
| Entity Type | Organization |
| Authorized Contact | ROBERT L VIVENTI Owner 781-769-3566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 17718) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 15645) |
| 1223G0001X Dentist, General Practice (Licence: MA 18350) | |
| 1223P0300X Dentist, Periodontics (Licence: MA 17964) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |