| NPI | 1437285848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W. WILSON Treasurer 781-729-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 21178) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |