| NPI | 1508176017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONG WON KIM Owner 978-744-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 21055) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21536) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |