NPI | 1457909004 |
---|---|
Entity Type | Organization |
Authorized Contact | BETHANY K POLNAR President 781-608-0307 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-08-27 |
Last Update Date | 2021-04-22 |