| NPI | 1558874172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI N. LISANN Owner/Dentist 617-738-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 16176) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |