| NPI | 1477725844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L HOLEY Office Manager 781-595-2542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MA 11389) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |