| NPI | 1558620997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY A. KING-BURKE Office Manager 617-723-4032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN19965) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MA DN12185) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2022-06-01 |