| NPI | 1457450165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AN-LOUISE JOHNSON President 781-545-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 20760) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-10-19 |