| NPI | 1477046704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGED EL- MALECKI Manager 617-949-0199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN20758) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |