| NPI | 1538144043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN P. PERLMAN Treasurer 781-599-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 12443) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 12700) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-08-22 |