| NPI | 1437313467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY TJAHJONO Dentist 617-947-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19510) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2008-07-18 |