| NPI | 1568609014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND GERALD NENTWICH Orthodontist 508-845-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 12628) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2009-01-20 |