| NPI | 1508915752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW L ZIZMOR President 617-738-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 13781) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-02-14 |