| NPI | 1487093555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER SCHROTT Owner 617-484-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN1855990) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |