| NPI | 1417961749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VOTCHE SERADERIAN Dentist/Owner 617-489-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17470) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 19460) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |