| NPI | 1417182437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LEA PERKINS Dentist 617-547-3934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 21641) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA 22266) |
| 1223P0700X Dentist Prosthodontics (Licence: MA 20292) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |