| NPI | 1508407214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MEMORY Employee/Owner 781-235-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-06-10 |