| NPI | 1477047710 |
|---|---|
| Doing Business As | WELLESLEY SQUARE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRADFORD R MATTISON Owner 617-930-6493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857389) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |