| NPI | 1508195140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MILLER Owner 508-926-8660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20028) |
| 1223E0200X Dentist, Endodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2015-05-11 |