| NPI | 1518002708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYNE STEVEN JOHNSON Owner 617-965-1225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA MA16753) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA MA16753) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |