| NPI | 1528118692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BLENKHORN DEMAREST President Owner Dentist 508-790-7801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 18955) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |