| NPI | 1538545637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROOZBEH KHOSRAVI Owner 617-466-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60504324) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |