| NPI | 1538408745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJEEVAN VIRK Manager 617-764-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855058) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2013-02-12 |