| NPI | 1457788200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASSAM EL-JAMOUS Periodontist 978-688-5646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: MA 21922) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-18 |