| NPI | 1427702802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMITA AGARWAL Owner 617-612-5022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-02-04 |