| NPI | 1437282357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT KARL TROSSELLO President 617-471-1890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 12314) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA 12314) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 12314) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |