| NPI | 1417548116 |
|---|---|
| Doing Business As | PROVINCETOWN HARBOR DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JORGE A RODRIGUEZ President 508-241-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2021-09-13 |