| NPI | 1457547754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH M. FANNING Office Manager 508-399-8130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16607/17935) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |