| NPI | 1447782461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK STEPHEN ZURN Owner 781-341-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA DN21571) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2018-05-24 |