| NPI | 1518269810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARHAMA ALVI-SHAH Owner 617-625-0543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |