| NPI | 1457423154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ALEXANDER BOUTSELIS Owner President 978-640-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 11196) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 18573) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |