| NPI | 1497961874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE I. GOLDBERG Owner 508-473-7632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19936) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |