| NPI | 1538254669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R GRESLA Endodontist 781-729-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 19631) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 12252) |
| 1223E0200X Dentist, Endodontics (Licence: MA 15909) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |