| NPI | 1477862761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MILLER Owner 781-837-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 20980) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2024-05-29 |