NPI | 1477667079 |
---|---|
Entity Type | Organization |
Authorized Contact | ZAKI M MUKDISSI President Owner 781-306-9644 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 21063) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 19475) |
1223P0300X Dentist, Periodontics (Licence: MA 19255) | |
Enumeration Date | 2006-08-19 |
Last Update Date | 2025-09-11 |