NPI | 1508977547 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES M MALKEMUS President 617-445-9880 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA MA11207) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2020-08-22 |