| NPI | 1538817101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNISYA BAGDONAS Director 617-328-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-05-23 |