| NPI | 1548558075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARIE PENZO Office Manager 617-471-0394 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 12177) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |