| NPI | 1487676342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN M CLANCY President 781-396-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20405) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2014-01-02 |