| NPI | 1467062935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D ABEL Sole Member 603-622-9441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2020-08-08 |