| NPI | 1477974020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUILLAUME LEPINE Sole Manager 508-695-4636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 21008) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |