| NPI | 1568404903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G MEARA Director 617-355-7252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2023-11-29 |